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Title: Activity of Pazopanib and Trabectedin in Advanced Alveolar Soft Part Sarcoma.
Authors: Stacchiotti, Silvia
Mir, Olivier
Le Cesne, Axel
Vincenzi, Bruno
Fedenko, Alexander
Maki, Robert G
Somaiah, Neeta
Patel, Shreyaskumar
Brahmi, Mehedi
Blay, Jean Y
Boye, Kjetil
Sundby Hall, Kirsten
Gelderblom, Hans
Hindi, Nadia
Martin-Broto, Javier
Kosela, Hanna
Rutkowski, Piotr
Italiano, Antoine
Duffaud, Florence
Kobayashi, Eisuke
Casali, Paolo G
Provenzano, Salvatore
Kawai, Akira
Keywords: Alveolar soft part sarcoma;Chemotherapy;Pazopanib;Sarcoma;Trabectedin
metadata.dc.subject.mesh: Adult
Antineoplastic Combined Chemotherapy Protocols
Follow-Up Studies
Middle Aged
Retrospective Studies
Sarcoma, Alveolar Soft Part
Survival Rate
Issue Date: 28-Jul-2017
Abstract: Alveolar soft part sarcoma (ASPS) is an exceedingly rare and orphan disease, without active drugs approved in the front line. Pazopanib and trabectedin are licensed for sarcoma treatment from second-line, but very little and contradictory data are available on their activity in ASPS. Lacking ongoing and/or planned clinical trials, we conducted a multi-institutional study involving the reference sites for sarcoma in Europe, U.S., and Japan, within the World Sarcoma Network, to investigate the efficacy of pazopanib and trabectedin. From May 2007, 14 of the 27 centers that were asked to retrospectively review their databases had identified 44 advanced ASPS patients treated with pazopanib and/or trabectedin. Response was evaluated by Response Evaluation Criteria in Solid Tumors 1.1. Progression-free survival (PFS) and overall survival (OS) were computed by Kaplan-Meier method. Among 30 patients who received pazopanib, 18 were pretreated (13 with other antiangiogenics). Response was evaluable in 29/30 patients. Best responses were 1 complete response, 7 partial response (PR), 17 stable disease (SD), and 4 progressions. At a 19-month median follow-up, median PFS was 13.6 months (range: 1.6-32.2+), with 59% of patients progression-free at 1 year. Median OS was not reached.Among 23 patients treated with trabectedin, all were pretreated and evaluable for response. Best responses were 1 PR, 13 SD, and 9 progressions. At a 27-month median follow-up, median PFS was 3.7 months (range: 0.7-109), with 13% of patients progression-free at 1 year. Median OS was 9.1 months. The value of pazopanib in advanced ASPS is confirmed, with durable responses, whereas the value of trabectedin appears limited. These results are relevant to defining the best approach to advanced ASPS. This retrospective study, conducted among the world reference centers for treatment of sarcoma, confirms the value of pazopanib in patients with advanced alveolar soft part sarcoma (ASPS), with dimensional and durable responses, whereas trabectedin shows a limited activity. Alveolar soft part sarcoma is resistant to conventional cytotoxic chemotherapy. Pazopanib and trabectedin are licensed for treatment of sarcoma from second line; in the lack of prospective clinical trials, these results are relevant to defining ASPS best management and strongly support initiatives aimed at obtaining the approval of pazopanib in the front line of the disease.
metadata.dc.identifier.doi: 10.1634/theoncologist.2017-0161
Appears in Collections:Producción 2020

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