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
5683 - Prevention of chemoradiation-related mucositis in patients with head and neck cancer using dexamethasone-based mouthwash: A phase II randomized double-blind, placebo-controlled study
Presenter: Naiyarat Prasongsook
Session: Poster Display session 1
Resources:
Abstract
5437 - Salivary cytokines and oral mucosa cells apoptosis in patients during hematopoietic cell transplantation: possible relationship with oral mucositis
Presenter: Luciana Corrêa
Session: Poster Display session 1
Resources:
Abstract
1483 - A randomized trial of sodium alginate prevention of radiation-induced esophagitis in patients with locally advanced NSCLC receiving concurrent chemoradiotherapy: OLCSG1401
Presenter: Toshihide Yokoyama
Session: Poster Display session 1
Resources:
Abstract
2047 - Taste and smell alterations (TSAs) in patients (pts) with stage II-III colon cancer (CC): a pilot within the PROTECT study
Presenter: Jeroen Derksen
Session: Poster Display session 1
Resources:
Abstract
5984 - Clinical characteristics are associated with acupuncture treatment response for xerostomia in cancer patients
Presenter: Wenli Liu
Session: Poster Display session 1
Resources:
Abstract
2845 - Psychosocial Distress of Adolescent and Young Adults with Cancer at Diagnosis: A Case-Matched Retrospective Cohort of 2045 Patients in British Columbia.
Presenter: Alannah Smrke
Session: Poster Display session 1
Resources:
Abstract
724 - Accuracy of distress thermometer to measure cancer-related mood disorders in Chinese patients with cancer
Presenter: Sudip Thapa
Session: Poster Display session 1
Resources:
Abstract
2357 - Modalities of biosimilar filgrastim use in clinical practice in >1000 patients receiving chemotherapy regimens with a rest period of ≤14 days: the TOPAZE study
Presenter: Jean Marc Phelip
Session: Poster Display session 1
Resources:
Abstract
1426 - The Effect of Increasing Doses of Pegfilgrastim (Peg) on Thrombocytopenia (T) in Breast Cancer (BC) Patients (pts) Receiving Taxotere (Doc), Doxorubicin, Cyclophosphamide (TAC) and Plinabulin (Plin)
Presenter: Douglas Blayney
Session: Poster Display session 1
Resources:
Abstract
712 - The use of intravenous ferric carboxymaltose without erythropoiesis-stimulating agents in the treatment of anemia in cancer patients undergoing chemotherapy with or without radiotherapy
Presenter: Hikmat Abdel-Razeq
Session: Poster Display session 1
Resources:
Abstract