Cancers (Basel). 2023 Jan 31. pii: 906. [Epub ahead of print]15(3):
Erlinda Maria Gordon,
Sant P Chawla,
Walter Andree Tellez,
Elan Younesi,
Sonu Thomas,
Victoria S Chua-Alcala,
Hripsime Chomoyan,
Chrysler Valencia,
Don Arlen Brigham,
Ania Moradkhani,
Doris Quon,
Amornchit Srikureja,
Steven G Wong,
William Tseng,
Noah Federman.
BACKGROUND: This Phase 1/2 study is based on the hypothesis that immune checkpoint inhibitors are more effective when given earlier in the course of the disease for advanced soft tissue sarcoma.
METHODS: Phase I endpoints-maximum tolerated dose in previously treated patients; Phase II endpoints-best response, progression free survival and overall survival and incidence of adverse events in previously untreated patients; Phase I treatments-escalating doses of trabectedin (1.0, 1.2, 1.5 mg/m2) as continuous intravenous infusion over 24 h every 3 weeks, 1 mg/kg of ipilimumab given intravenously every 12 weeks, and 3 mg/kg of nivolumab given intravenously every 2 weeks; Phase II treatments-maximum tolerated dose of trabectedin and defined doses of ipilimumab and nivolumab.
RESULTS: Phase I (n = 9)-the maximum tolerated dose of trabectedin was 1.2 mg/m2; Phase II (n = 79)-6 complete responses, 14 partial responses, 49 stable disease, 25.3% best response rate, 87.3% disease control rate; median progression-free survival, 6.7 months (CI 95%: 4.4-7.9), median overall survival, 24.6 months (CI 95%: 17.0-.); Grade 3/4 therapy-related adverse events (n = 92)-increased ALT (25%), fatigue (8.7%), increased AST (8.7%), decreased neutrophil count (5.4%) and anemia (4.6%).
CONCLUSION: SAINT is a safe and effective first-line treatment for advanced soft tissue sarcoma.
Keywords: alkylating agent; chemotherapy; immune checkpoint inhibitor; immunotherapy; ipilimumab; nivolumab and trabectedin; soft tissue sarcoma