Abstract 94P
Background
Pazopanib, a multi-targeted tyrosine kinase inhibitor, is employed in the treatment of various malignancies, including metastatic non-adipocytic soft tissue sarcoma (STS). Although its approval was granted based on improved progression-free survival (PFS) in a pivotal trial, its comparative efficacy against non-placebo treatments remains uncertain.
Methods
This systematic review and meta-analysis adhered to PRISMA guidelines to evaluate the efficacy and toxicity of pazopanib in treating Sarcomas. A comprehensive search of PubMed/MEDLINE and Scopus/ELSEVIER databases was conducted, covering the period from 2009 to 2023. The included studies were evaluated for quality using the MINORS, Newcastle-Ottawa Scale, and RoB2 tools. The descriptive objectives were to characterize the spectrum of toxicities and responses, focusing on studies assessing pazopanib as a monotherapy in sarcomas patients. A meta-analysis was performed to compare the efficacy of pazopanib with non-placebo systemic interventions, using both fixed-effect and random-effect models to calculate pooled hazard ratios (HRs) for PFS and overall survival (OS).
Results
Thirty-four studies were included, encompassing a wide range of study designs and quality. The analysis revealed variable objective response rates (ORR) across different sarcoma types, with the highest ORRs by RECIST observed in desmoid tumors (37.0%) and alveolar soft part sarcoma (35.5%). Common toxicities included hypertension, liver function test abnormalities, and fatigue, with significant variability in dose reductions and treatment interruptions across studies. The pooled HRs for PFS and OS were 1.10 (95% CI: 0.69–1.25) and 0.99 (95% CI: 0.63–1.35), respectively, indicating no significant advantage of non-placebo treatments respect to pazopanib.
Conclusions
Pazopanib demonstrated histology-specific efficacy in Sarcomas, with a manageable toxicity profile. Furthermore, it does not appear inferior to non-placebo interventions, including chemotherapy doublets, highlighting the need for further comparative studies to clarify its role in the therapeutic landscape of advanced Sarcomas.
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.