Abstract 4526
Background
Imatinib mesylate is approved in unresectable tumors and has been also proposed in the neoadjuvant setting in order to reduce tumor size and post-operative relapses for difficult to resect DFSP. The aim of this study was to evaluate the long-term results of neoadjuvant imatinib and other TKI used in DFSP.
Methods
The files of all patients with the following criteria seen from 2007 to 2017 in our center were collected in this retrospective study: a/histologically proven primary or recurrent DFSP with COL1A1-PDGFB translocation b/ difficult to treat but surgically manageable as assessed in pluridisciplinary tumor board, c/received first-line neoadjuvant TKI (imatinib, pazopanib). The primary endpoint was long-term progression-free survival (PFS).
Results
27 patients (median 42 years, range: 18-63) were included, of whom 9 (33%) had fibrosarcomatous transformation on pre-TKI biopsy. 10 patients had primary tumors and 17 presented recurrences. Median tumor size was 6 cm (range 3-30). 24 patients received imatinib (median dose= 600mg/day), 3 received pazopanib (median dose= 600mg/day) for a median of 7 months. The best MRI response to ITK treatment before surgery according to RECIST1.1 consisted of complete/partial response (33%) or stability (48%). DFSP was surgically removed in 24 patients (89%) after a median of 7 months and 2 surgeries. Two patients (7%) did not receive surgery because of metastasis progression. One other patient declined surgery. 23 of 24 patients surgically treated were disease-free after 50 months of median follow-up (range 10-133). One patient developed distant metastasis 37 months after the complete surgical resection. The median PFS was 44 months (range 10-133).The histological response localization was mainly patchy (n = 10) or diffuse (n = 7). The median percentage of therapeutic response surface was 65%.Treatment-related adverse events occurred in 23 patients (85%). 4 patients had grade 3 or higher toxicities (2 grade 3 and 4 neutropenia, 1 grade 3 cholestasis, 1 grade 3 nausea) requiring temporary treatment disruption and dose reductions.
Conclusions
TKI are effective neoadjuvant treatment for locally advanced or inoperable DFSP with long-term PFS and few severe adverse events.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1357 - Upfront atezolizumab chemoimmunotherapy-associated Immune-related adverse events in patients with advanced non-small cell lung cancer
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract
1851 - Nivolumab-induced and radiation recall pneumonitis in patients with non-small cell lung cancer: a multicenter real world analysis of 669 patients
Presenter: Nobuaki Mamesaya
Session: Poster Display session 1
Resources:
Abstract
851 - Retrospective analysis of immunotherapy prognostic scores in advanced NSCLC at Nottingham University Hospitals (UK)
Presenter: Cristina Lopez Escola
Session: Poster Display session 1
Resources:
Abstract
3639 - Applicability of lung immune prognostic index (LIPI) to predict efficacy of first-line pembrolizumab in advanced non-small-cell lung cancer (NSCLC)
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 1
Resources:
Abstract
2950 - Delayed Onset Immune Related Adverse Effects (IRAEs) of Pembrolizumab in Non-Small Cell Lung Cancer
Presenter: Haixi Yan
Session: Poster Display session 1
Resources:
Abstract
3659 - Clinical implication of multiplex IHC and serologic biomarkers on Hyperprogression in NSCLC patients receiving Immune checkpoint blockers in real world.
Presenter: Joori Kim
Session: Poster Display session 1
Resources:
Abstract
4882 - Local ablative treatment and treatment beyond progression for oligo-progression in stage IV non-small cell lung cancer after tumor response to anti-PD1 treatment
Presenter: Florian Guisier
Session: Poster Display session 1
Resources:
Abstract
1358 - Atezolizumab in combination with chemotherapy for first-line treatment of advanced non-small cell lung cancer: A systematic review and meta-analysis of randomized controlled trials (RCTs)
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract
2170 - Prognostic Impact of Metastatic Sites for Pembrolizumab Efficacy as First-line therapy in Patients with PD-L1 tumor proportion score (TPS) ≥ 50% Advanced Non–Small Cell Lung Cancer: A Retrospective Multicenter Study
Presenter: Hayato Kawachi
Session: Poster Display session 1
Resources:
Abstract
3051 - Impact of visceral fat area as independent predictive factor in patients with advanced non-small cell lung cancer treated with nivolumab
Presenter: Yuki Sato
Session: Poster Display session 1
Resources:
Abstract