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Efficacy of second and third lines of treatment in advanced soft tissue sarcomas: a real-world study

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Abstract

Background

Soft tissue sarcomas (STSs) are an uncommon and heterogeneous group of tumours. Several drugs and combinations have been used in clinical practice as second-line (2L) and third-line (3L) treatment. The growth modulation index (GMI) has previously been used as an exploratory efficacy endpoint of drug activity and represents an intra-patient comparison.

Methods

We performed a real-world retrospective study including all patients with advanced STS who had received at least 2 different lines of treatment for advanced disease between 2010 and 2020 at a single institution. The objective was to study the efficacy of both 2L and 3L treatments, analysing the time to progression (TTP) and the GMI (defined as the ratio of TTP between 2 consecutive lines of therapy).

Results

Eighty-one patients were included. The median TTP after 2L and 3L treatment was 3.16 and 3.06 months, and the median GMI was 0.81 and 0.74, respectively. The regimens most frequently used in both treatments were trabectedin, gemcitabine-dacarbazine, gemcitabine-docetaxel, pazopanib and ifosfamide. The median TTP by each of these regimens was 2.80, 2.23, 2.83, 4.10, and 5.00 months, and the median GMI was 0.78, 0.73, 0.67, 1.08, and 0.94, respectively. In terms of histotype, we highlight the activity (GMI > 1.33) of gemcitabine-dacarbazine in undifferentiated pleomorphic sarcoma (UPS) and in leiomyosarcoma, pazopanib in UPS, and ifosfamide in synovial sarcoma.

Conclusions

In our cohort, regimens commonly used after first-line STS treatment showed only slight differences in efficacy, although we found significant activity of specific regimens by histotype.

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Author notes

  1. Laura Gutierrez-Sainz and Sara Martinez-Fdez are contributed equally to this study.

Authors and Affiliations

  1. Department of Medical Oncology, La Paz University Hospital-Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain

    Laura Gutierrez-Sainz, Sara Martinez-Fdez, Jorge Pedregosa-Barbas, Jesus Peña, Maria Alameda, David Viñal, Julia Villamayor, Sergio Martinez-Recio, Pablo Perez-Wert, Ana Pertejo-Fernandez, Alejandro Gallego, Virginia Martinez-Marin, Pilar Zamora, Enrique Espinosa, Jaime Feliu & Andres Redondo

  2. Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Sergio Martinez-Recio

  3. Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain

    Alejandro Gallego

  4. Translational Oncology Group, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain

    Virginia Martinez-Marin, Pilar Zamora, Enrique Espinosa, Jaime Feliu & Andres Redondo

  5. Cátedra UAM-AMGEN, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Pilar Zamora, Enrique Espinosa, Jaime Feliu & Andres Redondo

  6. Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain

    Enrique Espinosa, Marta Mendiola & Jaime Feliu

  7. Molecular Pathology and Therapeutic Targets Group, IdiPAZ, Madrid, Spain

    Marta Mendiola

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  1. Laura Gutierrez-Sainz
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Corresponding authors

Correspondence to Laura Gutierrez-Sainz or Andres Redondo.

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Conflict of interest

AR reports honoraria and advisory/consultancy (MSD, AstraZeneca, GSK, and PharmaMar); research grant/funding to his institution (Eisai, PharmaMar, and Roche); travel/accommodation/expenses (AstraZeneca, PharmaMar, and Roche); and speakers bureau (MSD, AstraZeneca, GSK, Clovis, and PharmaMar), outside the submitted work. MM reports having received honoraria (MSD, AstraZeneca and GSK), research grant/funding to her institution (Eisai and PharmaMar), and travel/accommodation/expenses (AstraZeneca, GSK, PharmaMar, Roche and Pfizer) outside the submitted work. The rest of the authors have declared no conflicts of interest.

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Sergio Martinez-Recio and Alejandro Gallego were affiliated at the time of carrying out the work.

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Gutierrez-Sainz, L., Martinez-Fdez, S., Pedregosa-Barbas, J. et al. Efficacy of second and third lines of treatment in advanced soft tissue sarcomas: a real-world study. Clin Transl Oncol 25, 3519–3526 (2023). https://doi.org/10.1007/s12094-023-03221-6

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