5929 - Outcomes of metastatic soft tissue sarcoma treated with Pazopanib from dedicated medical oncology sarcoma clinic: A holistic care approach from a developing country

Background

Data for metastatic soft tissue sarcoma (STS) is sparse from developing countries. Pazopanib has demonstrated promising activity in the management of this disease. This study was carried out in the dedicated sarcoma medical oncology clinic in a tertiary referral center of Western India.

Methods

This is a retrospective analysis of prospective database from adult sarcoma medical oncology clinic at Tata Memorial Center, Mumbai from January 2035 to December 2018. The patients were provided holistic care through involvement of palliative care team, government fundings, local NGOs and sarcoma support groups. All statistical calculations were done using SPSS version 20.

Results

A total of 314 patients diagnosed with metastatic STS were registered in the dedicated medical oncology sarcoma clinic, 72% were males and median age 46 (16-79) years. Out of 314 patients, 60 (19%) patients received Pazopanib at some point of time during their treatment. Most common histology was synovial sarcoma (28%), leiomyosarcoma (26%), unspecified high grade spindle cell sarcoma (19%) and alveolar soft part sarcoma (12%). The median follow up duration was 18 (4-41) months. Median lines of prior therapy were 2 (0-2). Among 42 evaluable patients, there were 24% partial responses, 48% stable disease and 28% progressive disease. Median progression free survival was 5 (95% CI 3-7.3) months and median overall survival was 11 (95% CI 6.8-16.2) months. Important adverse events (>grade 1) included hand foot syndrome (10%), diarrhea (10%), hypothyroidism (10%), fatigue (8%) and hyperbilirubinemia/transaminitis (8%). Notably 50% patients required dose reduction and median dose was 600(200-800) mg daily.

Conclusions

Pazopanib was found to be a feasible treatment option for metastatic STS in India with internationally comparable outcomes. Median tolerated dose was lower than the standard 800 mg dose. Outcomes could be improved due to dedicated clinic with availability of targeted therapy with government help and local NGOs. This model of providing holistic care can be replicated in rare tumors in developing countries.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Tata Memorial Hospital, Mumbai.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.