Pazopanib in metastatic soft tissue sarcomas: Testing the waters in developing world

Area of Science:

• Oncology
• Medical Pharmacology

Background:

• Metastatic soft tissue sarcoma (M-STS) treatment options are limited, particularly in lower and middle-income countries.
• Pazopanib has shown efficacy in M-STS, but data from India is scarce.
• Investigating pazopanib's feasibility, efficacy, and optimal dosage in Indian M-STS patients is crucial.

Purpose of the Study:

• To evaluate the feasibility, efficacy, and optimal dose of pazopanib in Indian patients with M-STS.
• To assess toxicity, response rates, progression-free survival (PFS), and overall survival (OS).

Main Methods:

• Retrospective analysis of 72 M-STS patients treated with pazopanib from 2013-2018.
• Response assessed using RECIST 1.1 criteria via contrast-enhanced CT scans.
• PFS and OS evaluated using Kaplan-Meier method.

Main Results:

• Median follow-up was 17 months. Among 50 evaluable patients, objective response rate was 24% (12/50) and disease control rate was 74% (37/50).
• Median PFS was 5 months (95% CI 3-6.9), and median OS was 11 months (95% CI 6.8-15.2).
• Common adverse events included hand foot syndrome (28%), diarrhea (20%), fatigue (17%), and hypertension (17%). 40% required dose reduction, with a median tolerated dose of 600 mg.

Conclusions:

• Pazopanib is a feasible treatment for M-STS in India, yielding internationally comparable outcomes.
• A significant proportion of patients required dose modifications, with a median tolerated dose lower than the standard 800 mg.
• Further studies in larger cohorts are needed to confirm these findings and optimize pazopanib dosing in this population.