Outcomes of gemcitabine-docetaxel as second-line chemotherapy in patients of advanced soft tissue sarcoma: a retropsective analysis

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Soft Tissue Sarcomas
Presenter Kushal Gupta
Citation Annals of Oncology (2018) 29 (suppl_9): ix124-ix128. 10.1093/annonc/mdy443
Authors K. Gupta1, S. Parthiban1, S. Kumar2, S. Srinivas1, D.H. Vallathol1, R. Chanana1, G.S. Grewal1, N. Rathnasamy1, A. Goel1, J. Bajpai1
  • 1Medical Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN
  • 2Surgical Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN

Abstract

Background

Soft tissue sarcomas (STS) are a heterogenous group of malignancies of about 50 different subtypes. About 50% develop fatal metastatic recurrences, with median OS ranging from 11 to 18 months from diagnosis.As first line, almost 30% of patients treated with doxorubicin and 7-38% patients treated with ifosphamide show objective response . Treatment options in relapsed disease is limited. Single agent gemcitabine,or combination with docetaxel have been used in STS, mainly leiomyosarcomas, with conflicting results.Study aims to retrospectively analyse the results of advanced STS treated with gemcitabine-docetaxel.

Methods

Retrospective study of 40 patients (age 18-60 years, PS 0-2) of advanced/metastatic STS who received at least 3 cycles Gemcitabine-Docetaxel as part of palliative chemotherapy evaluated to look for clinical benefit and tolerance to chemotherapy, including any Grade 3 or Grade 4 toxicity (CTCAE v4.03) . Response scans after 3 cycles of Gemcitabine-Docetaxel was evaluated and comparison of the lesion with pre-treatment scans (RECIST v1.1).

Results

Median OS was 2.76 years (1007 days) (R = 160 - 4708 days), median PFS (first recurrence) was 0.7 years (255 days), median PFS (second recurrence) was 0.4 years (146 days) and median PFS (third recurrence) was 0.76 years (277 days). After 6 cycles, 18 out of 40 patient (ORR=45%) had sustained responses. Seven patients had grade 3 (17.5%) and 1 patient had grade 4(2.5%) CINV. No patient had Grade ≥2 CIPN (0%). Grade 3 fatigue was seen in 1 patient (2.5%). Two patients (5%) had grade 3 diarrhea. Anemia was moderate in 6(15%) and severe in 1(2.5%) patient, requiring transfusion. Grade 3 mucositis in 2 (5%) of the patients. Grade 3 neutropenia in 6(15%) patients. Of these, febrile neutropenia 4 patients(10%) had grade 2 and 1 patient (2.5%) had grade 3 febrile neutropenia, requiring prolonged iv antibiotics in 6 patients and short-term ICU stay in 1 patient. No deaths due to toxicity related to the regimen was noted.

Conclusions

Gemcitabine and Docetaxel combination is a viable treatment alternative in patients with soft tissue sarcomas, having a good ECOG PS (0-2) with overall response (CR+PR+SD) of 45% with acceptable and manageable toxicity profile.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Tata Memorial Hospital, Parel, Mumbai, Maharsahtra, India. Pin: 400012.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.