Patterns of care for patients with advanced soft tissue sarcoma: experience from Australian sarcoma services

Bae, Susie; Crowe, Philip; Gowda, Raghu; Joubert, Warren; Carey-Smith, Richard; Stalley, Paul; Desai, Jayesh

doi:10.1186/s13569-016-0052-4

Cited by 14 publications

(13 citation statements)

References 20 publications

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“…Anthracycline-based chemotherapy is recommended as a standard-of-care in palliative settings in well-known guidelines such as the National Comprehensive Cancer Network (NCCN) and the European Society of Medical Oncology (ESMO). In this study, anthracycline-based chemotherapy was the most frequent treatment for advanced STS (50%), which is consistent with previous studies from other countries such as Germany, the United Kingdom and Australia [26-28]. However, when analyzed by specific regimen, doxorubicin plus ifosfamide (AI) combination therapy was the most frequently used, whereas doxorubicin monotherapy was most frequently used in Germany, the United Kingdom, and Australia [26-28].…”

Section: Discussionsupporting

confidence: 89%

Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea

et al. 2019

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PurposeA soft tissue sarcoma (STS) is a rare type of cancer, accounting for 1% of adult solid cancers. The aim of the present study is to determine the incidence of localized and advanced STS in Korean patients, their treatment patterns, and the survival of patients by disease status.Materials and MethodsThe STS patient cohort was defined using National Health Insurance Service medical data from 2002 to 2015. Incidence, distribution, anatomical location of tumors, survival rates (Kaplan-Meyer survival function) and treatment patterns were analyzed by applying different algorithms to the STS cohort containing localized and advanced STS cases.ResultsA total of 7,813 patients were diagnosed with STS from 2007 to 2014, 4,307 were localized STS and 3,506 advanced STS cases. The total incidence of STS was 2.49 per 100,000 person- years: 1.37 per 100,000 person-years for localized STS and 1.12 per 100,000 person-years for advanced STS. The 5-year survival rate after diagnosis was 56.4% for all STS, 82.4% for localized, and 27.2% for advanced STS. Half of the advanced STS patients (49.98%) received anthracycline-containing chemotherapy as initial treatment after diagnosis.ConclusionThis study provides insights into localized and advanced STS epidemiology, treatment patterns and outcomes in Korea, which could be used as fundamental data in improving clinical outcomes of STS patients in the future.

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Section: Discussionsupporting

confidence: 89%

Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea

et al. 2019

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“…The addition of olaratumab to first line therapy is likely to solidify the use of doxorubicin in the first line [ 17 ]. Prior studies of first-line treatment have found that the most common regimens were doxorubicin monotherapy (34%) or an anthracycline + ifosfamide (30%) [ 11 ], anthracycline-based (44%) or gemcitabine-based (28%) [ 13 ], doxorubicin (± ifosfamide) (46%) [ 12 ], or doxorubicin (± ifosfamide) (66%) [ 18 ]. Docetaxel + gemcitabine may be preferred for certain mSTS including leiomyosarcomas and undifferentiated pleomorphic sarcomas (UPS) [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…These results suggest widespread use of gemcitabine in LOT2 prior to pazopanib’s US availability, either alone or in combination with docetaxel, and less variation in LOT2 regimen preference across different study populations. In contrast, Bae and colleagues found that 53% used ifosfamide in LOT2 in an Australian advanced STS population, although pazopanib was sporadically used as subsequent LOTin Bae’s study population following its availability in Australia in March of 2014 [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study of treatment patterns among patients with metastatic soft tissue sarcoma in the US

et al. 2017

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BackgroundSince treatment patterns in metastatic soft tissue sarcoma (mSTS) have not been studied subsequent to US approval of pazopanib in 2012, this study sought to examine mSTS treatment patterns by line of therapy, including regimen and duration of therapy.MethodsThis retrospective study employed administrative claims from a large US health plan from 1/2006–9/2015. Adult mSTS patients were required to have an NCCN-recommended therapy and be continuously enrolled in the health plan during the study period. The most frequent regimens for distinct lines of therapy (LOT) were assessed. Sensitivity analyses evaluated changes to study findings using two alternate medical and pharmacy claims diagnostic algorithms to define the STS study population.ResultsAmong 555 patients with mSTS, mean age was 59 years and 54% were male. During the study period, 41% of patients initiated ≥ 2 LOTs; 16% had ≥ 3 LOTs and 5% had ≥ 4 LOTs. Docetaxel + gemcitabine was most common in LOT1, pazopanib in LOT2 and LOT3, and doxorubicin in LOT4. The five most common LOT1 regimens represented 53% of patients; among the remaining 47%, the most common regimen represented < 6% of patients. Among patients with pazopanib in LOT2 and LOT3, the most common prior regimen was docetaxel + gemcitabine (47% and 30% respectively). Kaplan–Meier estimation of median treatment duration overall for LOT1 was 3.5 months, while for LOT2 and LOT3, median treatment duration was 2.9 and 3.3 months, respectively. For both sensitivity analyses, patient demographic and clinical characteristics were similar to the original study population, and the five most frequently used regimens in LOT1 and LOT2 were similar among the three populations regardless of the population selection criteria employed.ConclusionChoice of regimen by LOT among patients with mSTS is varied; < 65% of patients in any LOT received the five most common regimens. Pazopanib, the only approved targeted therapy, is primarily used in second and later lines of therapy and is mostly given post docetaxel + gemcitabine.

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“…However, many patients develop severe symptoms like pain or local complications due to uncontrolled progressions of localized lesions, which are generally amenable to palliative RT. According to a recent survey from Australia, 37% of locally advanced or metastatic STS patients received palliative RT during their course of disease [97], mainly to symptomatic lesions of bone and lung or mediastinum. Although this comprises a substantial number of patients, the literature regarding efficacy, side effects, and optimal dose and fractionation schedules specifically for STS patients is very scarce.…”

Section: Palliative Rtmentioning

confidence: 99%

Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

Roeder

2020

Cancers

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Radiation therapy (RT) is an integral part of the treatment of adult soft-tissue sarcomas (STS). Although mainly used as perioperative therapy to increase local control in resectable STS with high risk features, it also plays an increasing role in the treatment of non-resectable primary tumors, oligometastatic situations, or for palliation. Modern radiation techniques, like intensity-modulated, image-guided, or stereotactic body RT, as well as special applications like intraoperative RT, brachytherapy, or particle therapy, have widened the therapeutic window allowing either dose escalation with improved efficacy or reduction of side effects with improved functional outcome. This review summarizes the current evidence for RT in adult STS including typical indications, outcomes, side effects, dose and fractionation regimens, and target volume definitions based on tumor localization and risk factors. It covers the different overall treatment approaches including RT either as part of a multimodal treatment strategy or as a sole treatment, namely its use as an adjunct to surgery in resectable STS (perioperative RT), as a primary treatment in non-resectable tumors (definitive RT), as a local treatment modality in oligometastatic disease or as palliative therapy. Due to the known differences in clinical course, general treatment options and, consequently, outcome depending on lesion localization, the main part of perioperative RT is divided into three sections according to body site (extremity/trunk wall, retroperitoneal, and head and neck STS) including the discussion of special applications of radiation techniques specifically amenable to this region. The review of the current evidence is accompanied by a summary on ongoing clinical research pointing at future directions of RT in STS.

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Patterns of care for patients with advanced soft tissue sarcoma: experience from Australian sarcoma services

Cited by 14 publications

References 20 publications

Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea

Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea

A retrospective cohort study of treatment patterns among patients with metastatic soft tissue sarcoma in the US

Radiation Therapy in Adult Soft Tissue Sarcoma—Current Knowledge and Future Directions: A Review and Expert Opinion

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