Abstract 307P
Background
Uterine leiomyosarcoma (uLMS) is a rare, aggressive subtype of uterine cancer. Metastatic uLMS is known for its poor prognosis. uLMS have recurrence rates of 50-70%, with an overall 5-year survival less than 15% in advanced stages. The main treatment for localized uLMS is surgery. For unresectable or advanced uLMS, other options such as chemotherapy and hormonal therapy can be offered.
Methods
We conducted a search across 5 databases, Google Scholar, Science Direct, PubMed, EMBASE & Scopus for studies within the last 15 years. We included studies that recorded combination chemotherapy/hormonal therapy as the treatment regime for histologically confirmed metastatic/unresectable uLMS. We excluded studies with <5 samples, those that included other uterine cancers & non-English articles. Quality of the studies were assessed by the Newcastle-Ottawa Scale (NOS).
Results
We found 10 studies, with a total of 427 metastatic uLMS patients. Combination chemotherapy had much higher rates of response & progression-free survival compared to hormonal therapy. Gemcitabin-docetaxel was the most common regime, with high effectivity. Addition of targeted therapy did not improve outcomes significantly. However, combination chemotherapy had a much higher proportion of grade 3-4 toxicity. Most common side effects were myelosuppression, fatigue & liver toxicity, resulting in much higher rates of therapy discontinuation due to the side effects. Hormonal therapy was much more tolerable, with common side effects including hot flashes, weight gain, muscle pain & joint pain. Unfortunately, hormonal therapy had higher proportions of therapy discontinuation due to disease progression, and had lower response rates, shorter overall survival & progression-free survival. Overall, patient-specific factors play a crucial role in treatment decisions. Hormonal therapy has a more attractive side effect profile, while combination chemotherapy though more aggressive may be favorable in cases requiring rapid tumor control.
Conclusions
uLMS is an aggressive cancer with hormonal therapy & combination chemotherapy as treatment options. Hormonal therapy has a better side effect profile, with chemotherapy having better effectivity and survival rates.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
P. Angel.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
238P - Enfortumab-vedotin for metastatic urothelial carcinoma refractory to platinum-based chemotherapy and immune checkpoint inhibitors: A single institution experience
Presenter: Yuki Endo
Session: Poster Display
Resources:
Abstract
239P - Elevated baseline C-reactive protein is a prognostic indicator for OS in patients with metastatic non clear cell renal cell carcinoma treated with systemic therapy
Presenter: Ryuichi Mizuno
Session: Poster Display
Resources:
Abstract
240P - Efficacy and safety of first-line combination therapy with ipilimumab + nivolumab for metastatic renal cell carcinoma in a single institution in Japan
Presenter: Naoya Nagaya
Session: Poster Display
Resources:
Abstract
241P - First-line cabozantinib in metastatic renal cell carcinoma (mRCC): A real-world exploratory study from eastern India
Presenter: Tamojit Chaudhuri
Session: Poster Display
Resources:
Abstract
244P - Clinicopathologic feature and treatment outcome of metastatic non clear cell kidney cancer: A single centre experience from India
Presenter: Somnath Roy
Session: Poster Display
Resources:
Abstract
245P - The role of TGF-β in the formation of the protumor phenotype of circulating neutrophils at different stages of renal cancer
Presenter: Ilseya Myagdieva
Session: Poster Display
Resources:
Abstract
246P - Impact of renal impairment on first-line treatment in metastatic urothelial cancer
Presenter: Stephanie Wakeling
Session: Poster Display
Resources:
Abstract
247P - Adjuvant chemoradiotherapy in the management of bladder adenocarcinoma compared to multiple treatment modalities
Presenter: Othman Mohammed
Session: Poster Display
Resources:
Abstract
248P - Screening zinc homeostasis-related genes identifies metallothionein 1H (MT1H) as a potential prognostic biomarker in clear cell renal cell carcinoma (ccRCC)
Presenter: Eyad Al Masoud
Session: Poster Display
Resources:
Abstract
249P - The prognostic utility of Progestogen associated Endometrial protein (PAEP) gene expression in clear cell renal cell carcinoma (ccRCC)
Presenter: Leen Lataifeh
Session: Poster Display
Resources:
Abstract