Prognostic factors for post-progression survival after trabectedin treatment in patients with advanced soft tissue sarcoma

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Soft Tissue Sarcomas
Presenter Shintaro Iwata
Citation Annals of Oncology (2018) 29 (suppl_9): ix124-ix128. 10.1093/annonc/mdy443
Authors S. Iwata1, K. Yonemori2, A. Arakawa3, A. Maejima4, F. Nakatani1, E. Kobayashi1, T. Mori1, K. Sudo2, E. Noguchi2, T. Hirose1, S. Komatsubara1, H. Fujimoto4, C. Ogawa3, K. Tamura2, A. Kawai1
  • 1Department Of Musculoskeletal Oncology And Rehabilitation, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 2Department Of Breast And Medical Oncology, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 3Department Of Pediatric Oncology, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 4Department Of Urology, National Cancer Center Hospital, 104-0045 - Tokyo/JP

Abstract

Background

In the randomised Phase 3 trial, compared with dacarvazine, trabectedin improved progression-free survival in patients with advanced soft tissue sarcoma (ASTS); however, it did not improve overall survival. An analysis of the post-progression survival (PPS) would help explain the discrepancy; however, the prognostic factors for PPS in ASTS patients are ill-defined. This analysis investigates the clinical factors affecting PPS in ASTS patients treated with trabectedin.

Methods

ASTS patients who developed progressive disease (PD) while receiving treatment with trabectedin in our hospital from 2016 to 2018 were eligible for this study. Kaplan-Meyer estimates of PPS, which included the time from PD while on trabectedin treatment until death by any cause to final follow-up, were computed. Potential prognostic factors including disease extent (locally advanced disease vs metastasis), PD type (new lesion vs lesion increasing in size), clinical benefit (PD vs PR + SD), number of treatment courses and additional treatment after PD were analysed using Cox proportional hazards models.

Results

Thirty-three patients were included in this study. In the assessment of PD type, new lesions developed in 15 patients (45%), which was correlated with a poorer PPS (HR 6.14, p = 0.0028). In addition, patients who did not receive any treatments after PD (n = 14, 42%) or patients with metastasis (n = 27, 82%) were correlated with a poorer PPS (HR 4.29, p = 0.014 and HR 7.16, p = 0.039, respectively). By contrast, clinical benefits or the number of treatment courses were not associated with PPS.

Conclusions

This study demonstrated that PD type, additional treatments after PD and disease extent influenced PPS of ASTS patients treated with trabectedin. These findings should be considered for use as new markers in future ASTS clinical trials.

Editorial acknowledgement

Enago.

Clinical trial identification

Legal entity responsible for the study

Dr. Shintaro Iwata.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.