Treatment patterns and survival in an exhaustive French cohort of pazopanib-eligible patients with metastatic soft tissue sarcoma (STS)

Abstract

BackgroundThe French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07.MethodsThe database included diagnosis/histology, surgery, radiotherapy, systemic treatments and treatment response. Treatment patterns and outcomes of patients with metastatic disease, excluding adipocytic sarcoma and GIST were analyzed.ResultsOf 888 total patients, 145 were included based on having metastatic disease and appropriate subtypes. All patients received treatment with systemic therapy being most common (74%, n = 107), followed by radiotherapy (30%, n = 44) and surgery (23%, n = 33). Doxorubicin, alone or in combination, was the most common first line systemic therapy (65%, n = 46). Drugs without license in sarcoma were used in 38–83% of treatments depending on treatment line. 24% of frontline patients demonstrated an objective response, decreasing to 11% objective responses in second line but no responses were documented beyond second line, with median PFS declining with each additional line. Median PFS also declined in patients receiving surgery compared to those receiving no surgery (8–15 m vs 5 m). Median OS from metastatic diagnosis for patients receiving systemic therapy was double that of patients without systemic treatment (24 m vs 12 m, p = 0.007).ConclusionsOutcomes in this population were poor and declined with successive treatment. However, results suggest that further anticancer therapies in recurrent sarcoma might be beneficial.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3057-3) contains supplementary material, which is available to authorized users.

Safety and efficacy of Pazopanib in advanced soft tissue sarcoma: PALETTE (EORTC 62072) subgroup analyses

“…As might be expected, the number of lines of previous systemic therapy was a significant prognostic factor for PFS among pazopanib recipients in the PALETTE study (0–1 vs 2–4 prior lines of therapy, HR [95% CI]: 0.72 [0.53–0.99]; P = 0.04) [2]. This finding is in agreement with “real-world evidence” demonstrating that patients with aSTS exhibit a decline in mPFS with each additional line of previous therapy [14]. The randomized, phase 2 EPAZ trial (NCT01861951) demonstrated that pazopanib was noninferior to doxorubicin with respect to PFS in the first-line treatment of STS in patients more than 60 years of age [15].…”

Treatment Patterns and Healthcare Resource Utilization among Patients with Advanced or Metastatic Soft Tissue Sarcoma in US Community Practices

“…As observed in previously published observational studies of patients with advanced or metastatic STS, a high degree of treatment heterogeneity was observed across lines of therapy in this study [10,11,17,18]. In this study, 43 unique regimens were observed with 117 first-to second-line treatment sequences.…”

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

“…The average age of patients with clinically advanced STS in our study was 56.1 years, and 53.2 years for localized STS patients. These figures are slightly lower than those reported by the Japanese registry (58.3) [15], the Surveillance, Epidemiology, and End Results report (SEER, 58 years) [16] and for a French cohort (61.5) [17]. Our study showed that the proportion of patients in the age category 20-40 was 18.6%; this was higher than in other solid tumors (lung, 1%; liver cancer, 2%; gastric cancer, 3%; colorectal cancer, 3%; and breast cancer, 10%).…”