1960P - Clinical outcomes of the patients with alveolar soft part sarcoma developed brain metastasis

Background

Bone and soft tissue sarcomas are uncommon neoplasms that rarely metastasize to the brain. Alveolar soft tissue sarcomas (ASPS) have been reported to have a higher propensity to develop brain metastasis (BM) than other sarcomas. Our study aimed to retrospectively scrutinize the clinical outcome of BM in ASPS.

Methods

35 patients diagnosed with ASPS between 2006 and 2021 were identified from our database. We evaluated the presence or absence of BM, age at diagnosis, gender, primary lesion site, tumor size, other distant metastases at diagnosis, and prognosis. We compared these clinical characteristics between patients with BM and those without BM (nBM). In the BM group, we also assessed symptoms, duration between diagnosis and BM, treatment for BM, and outcomes.

Results

Fifteen patients (43%) exhibited BM. We observed no significant difference in age at diagnosis, gender, primary lesion site, tumor size, or other distant metastases at diagnosis or median overall survival, compared to the nBM group. Seven cases were asymptomatic when BM was diagnosed. Most symptoms were headache and visual disturbance. The mean duration between diagnosis and BM was 46 months (range: 0-189). BM treatment consisted of gamma-knife radiosurgery in 10 cases, multi-targeted kinase inhibitors (TKI) (pazopanib and/or sunitinib) in eight cases, surgery in three cases, and whole-brain irradiation in three cases. After receiving sunitinib treatment, two patients developed brain hemorrhages. The survival after BM was 33 months (range: 0.5-104).

Conclusions

Approximately half of the ASPS cases included in our study developed BM, with 47% of ASPS patients being asymptomatic at the time of BM detection. Periodic imaging, including the head region, may be advisable. Our analysis did not identify specific clinical features that predict BM in ASPS patients. Selective irradiation and chemotherapy have recently emerged as potential therapeutic options for treating BM in ASPS. These advances may contribute to improved prognosis after BM. However, potential serious adverse events associated with these treatments should be carefully considered. In particular, patients receiving TKI therapy may be at risk for brain hemorrhages and should be closely monitored and managed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

E. Kobayashi.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.