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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

5875 - Trabectedin and radiotherapy in advanced sarcoma: experience of a Reference Center

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Cytotoxic Therapy;  Radiation Oncology

Tumour Site

Sarcoma

Presenters

Irene Carrasco Garcia

Citation

Annals of Oncology (2018) 29 (suppl_8): viii576-viii595. 10.1093/annonc/mdy299

Authors

I.C. Carrasco Garcia1, N. Hindi2, J. Peinado3, I. Rincon3, M. Cordeiro4, F.J. Jimenez5, A. Falcon Gonzalez1, R. Lasso de la Vega1, M. Noguer Mediavilla1, P. Sancho Marquez1, J. Martin-Broto2

Author affiliations

  • 1 Medical Oncology Department, Hospital Universitario Virgen del Rocio, 41013 - Sevilla/ES
  • 2 Medical Oncology, Instituto de Biomedicina de Sevilla (IBIS) /CSIC/US, Hospital Univ. Virgen de Rocio, Seville/ES
  • 3 Radiation oncology, Hospital Universitario Virgen del Rocio, 41013 - Sevilla/ES
  • 4 Medical Oncology, Hospital Universitario Son Espases, 41013 - Palma de Mallorca/ES
  • 5 Medical Oncology, Hospital Universitario Juan Ramon Jimenez, Huelva/ES

Resources

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Abstract 5875

Background

In patients with advanced soft tissue sarcomas (STS) there is low probability to obtain tumor shrinkage with second-line drugs. That means that patients requiring volumetric response to palliative relief have few therapeutic options since active second-line drugs in STS exhibit less than 10% of RECIST response. Trabectedin (T) has shown to be synergistic with radiation therapy (RT) in preclinical experiments. Additionally, a substantial activity of T+RT has recently been reported in a phase I trial with 71% of overall response rate (ORR) in the irradiated nodules.

Methods

Cases with advanced STS treated with T at standard dose of 1.5 mg/m2 24-h infusion and RT 30-39 Gy (3 Gy per fraction) were collected for this retrospective series from one sarcoma reference center. RT was started 24 h later the trabectedin initiation. ORR according to RECIST 1.1, progression free survival (PFS) and overall survival (OS) were analized.

Results

Twenty patients with median age 51 (27-77) and male/female 9/11 were selected. STS subtypes were uterine and somatic leiomyosarcoma 5(25%) and 4 (20%) respectively, high grade myxoid liposarcoma 4 (20%) and non-L STS 7 (35%). All but one patient received previous systemic lines, 2 (0-6). Response assessment was, 5 (25%) PR, 9 (45%) SD and 6 (30%) PD. Considering only radiated lesions, response evaluation was as follows: PR 5 (25%), SD 13 (65%) and 2 (10%) PD. There were 8/12 minor responses. Patients with non-L sarcomas also had disease control (1 myxofibrosarcoma, 2 sarcoma NOS achieved minor responses, 1 fibrosarcoma, 1 malignant peripheral nerve sleath tumor, 1 synovial sarcoma with SD). There were not toxic deaths and only one G3 SAE (transaminitis). No dose-reductions or interruptions were registered. With a median follow-up of 11.2 mos (4.4-36), there were 11 progression and 6 death events. The median of PFS was 9.9 months (6.5-13.2 months) while the median OS has not been reached.

Conclusions

T + RT have shown relevant clinical activity in advanced STS, whatever the histotype and location. In 70% of cases there was some shrinkage in radiated lesions bringing up the opportunity of better disease control. Both ORR and PFS were clearly superior with T + RT than historical results obtained with T alone.

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

N. Hindi: Research funding to institution: Eisai, Novartis, PharmaMar; Travel funding: PharmaMar. J. Martin-Broto: Advisory: PharmaMar; Research funding to institution: Eisai, Novartis, PharmaMar; Travel funding: PharmaMar. All other authors have declared no conflicts of interest.

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