bims-myxlip 2022-10-09 papers

Issue of 2022–10–09
six papers selected by
Laura Mannarino, Humanitas Research

Int J Cancer. 2022 Oct 04.

Trabectedin use in soft-tissue sarcoma patients in a real-world setting: data from an Italian national drug-access registry.

Bruno Vincenzi, Andrea Napolitano, Alessandro Comandone, Roberta Sanfilippo, Simone Celant, Pier P Olimpieri, Susanna Di Segni, Pierluigi Russo, Paolo G Casali.

Trabectedin is a marine-derived anticancer drug approved for the treatment of patients with advanced soft-tissue sarcomas (STS). Here, we aimed to analyze its use in a large cohort of STS patients treated in Italy in a real-world setting. Data on STS patients treated with trabectedin in Italy were prospectively collected from January 2013 to December 2019 by the national drug regulator, the Italian Medicines Agency (AIFA). Time-to-off-treatment (TToT) was defined as the time between the initial prescription of trabectedin and the date of treatment discontinuation for any cause. The impact of the different baseline covariates, including the initial prescribed dose of trabectedin, on TToT was evaluated using an accelerated failure time (AFT) models with log-logistic distribution. In total, we analyzed data from 2,633 sarcoma patients and 14,950 individual cycles of trabectedin. The median number of cycles of trabectedin received per patient was 3 (interquartile range 2-7). The labelled 1.5 mg/sqm dose was used in 27.3% of all first prescriptions. Overall, the median TToT was 93 days. In the final AFT model, the variables significantly associated to longer TToT were female gender (+13% increase in TToT); ECOG performance status 0 (+50%); histological diagnosis of leiomyosarcoma (+22%), well-differentiated/dedifferentiated liposarcoma (+72%) or myxoid liposarcoma (+61%); receiving treatment in a high-volume center (+23%). In this large real-world cohort of STS patients treated with trabectedin, our findings support the use of trabectedin in STS patients, in particular in leiomyosarcoma and liposarcoma patients, and highlight the role of treatment center volume in their management.

Keywords: AIFA; Italy; registry; sarcoma; trabectedin

DOI: https://doi.org/10.1002/ijc.34309

Future Oncol. 2022 Oct 06.

The role of trabectedin as second-line treatment of advanced soft tissue sarcoma: update of key efficacy and safety data.

Axel Le Cesne.

Keywords: advanced soft tissue sarcoma; sarcoma guidelines; second-line treatment; trabectedin

DOI: https://doi.org/10.2217/fon-2022-0516

Future Oncol. 2022 Oct 06.

Experience with second-line trabectedin in daily clinical practice: case studies.

Javier Martín-Broto, Nadia Hindi, Giovanni Grignani, Alessandra Merlini, Tony Ibrahim, Axel Le Cesne.

As a recommended second-line option for advanced soft tissue sarcoma, trabectedin can provide the necessary balance between long-term tumor control and preserved quality of life. Three case studies illustrate the long-lasting responses that patients can achieve with second-line trabectedin. A female patient with metastatic leiomyosarcoma maintained disease control for 2 years with trabectedin (× 41 cycles) with excellent tolerability and no relevant adverse events. At the time of writing, a male patient with a metastatic solitary fibrous tumor was asymptomatic after 30 cycles of trabectedin and treatment was ongoing. A young male patient with a recurrent, nonresectable, retroperitoneal myxoid/round cell liposarcoma was able to continue his sporting activities (triathlons) over 2 years with trabectedin (× 14 cycles) plus watchful waiting.

Keywords: advanced leiomyosarcoma; growth modulation index; long responder; myxoid/round cell liposarcoma; soft tissue sarcoma; solitary fibrous tumor; trabectedin

DOI: https://doi.org/10.2217/fon-2022-0519

Future Oncol. 2022 Oct 06.

A review of the efficacy of trabectedin as second-line treatment of advanced soft tissue sarcoma.

Axel Le Cesne, Javier Martín-Broto, Giovanni Grignani.

The goal of second-line therapy for most patients with advanced soft tissue sarcoma is long-term tumor control without detriment to quality of life. Clinical practice guidelines recommend trabectedin as a second-line option for advanced soft tissue sarcoma as it can provide the necessary balance between these interwoven goals. Cumulative experience with trabectedin in clinical trials and clinical practice has informed its usage such that greater benefit can be derived. In particular, use in earlier lines allows more patients to achieve prolonged tumor control (six or more cycles). Efficacy outcomes are superior when trabectedin is administered as second- versus later-line therapy and when it is used continuously until disease progression.

Keywords: advanced soft tissue sarcoma; efficacy; progression-free survival; trabectedin

DOI: https://doi.org/10.2217/fon-2022-0517

Pediatr Blood Cancer. 2022 Oct 02. e30005

Irinotecan dose schedule for the treatment of Ewing sarcoma.

Emily K Slotkin, Paul A Meyers.

Irinotecan and temozolomide achieve objective responses in patients with Ewing sarcoma that recurs after initial therapy. Optimal dose schedules have not been defined. We reviewed published series of patients treated with irinotecan and temozolomide for Ewing sarcoma that recurred after initial therapy. We compared objective response rates for patients who received 5-day irinotecan treatment schedules to response rates for patients who achieved 10-day irinotecan treatment schedules. Among 89 patients treated with a 10-day irinotecan schedule, there were 47 objective responses (53%). Among 180 patients treated with a 5-day irinotecan schedule, there were 52 responses (29%). In the treatment of recurrent Ewing sarcoma, investigators should consider the use of a 10-day schedule for administration of irinotecan.

Keywords: Ewing sarcoma; dose schedule; irinotecan

DOI: https://doi.org/10.1002/pbc.30005

Future Oncol. 2022 Oct 06.

Trabectedin as second-line treatment in advanced soft tissue sarcoma: quality of life and safety outcomes.

Giovanni Grignani, Axel Le Cesne, Javier Martín-Broto.

The choice of second- and later-line options for advanced soft tissue sarcoma (aSTS) should always be considered from the patient's perspective, taking into account the potential impact of treatment on daily activities and quality of life. This review examines data on the safety of trabectedin in the management of patients with aSTS as reported in clinical trials and real-world studies. Evidence indicates that trabectedin exhibits an acceptable and manageable safety profile and is compatible with daily activities. Trabectedin is associated with low rates of toxicity-related discontinuations, few potentially life-threatening toxicities, a lack of apparent cumulative toxicities and low rates of grade 3/4 nausea, vomiting and fatigue. Trabectedin represents a valuable second-line option for aSTS, including in elderly patients.

Keywords: advanced soft tissue sarcoma; quality of life; safety; tolerability; trabectedin

DOI: https://doi.org/10.2217/fon-2022-0518