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Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
Published on: April 11, 2018
Pazopanib in rare histologies of metastatic soft tissue sarcoma
Babita Kataria1, Aparna Sharma2,3, Bivas Biswas4
1Department of Medical Oncology, National Cancer Institute, Badsa, Jhajjar, Haryana, 124105, India.
Background:
Uncommon histopathological subtypes account for less than 5% cases of soft tissue sarcoma (STS) and unclassified STSs comprise another 16%, these are often chemotherapy-resistant, with a dismal outcome in unresectable/metastatic disease. Prospective studies on the use of pazopanib in this cohort of patients are lacking in the literature. Here, we describe the safety and efficacy of pazopanib in rare histologies of advanced STS.
Materials And Methods:
We conducted a retrospective study at two tertiary cancer centres in India, evaluating 33 cases of rare subtypes of STS, who received pazopanib as per institutional protocol between January 2013 and December 2019. Patients who received pazopanib for unresectable/metastatic disease were enrolled in this study for clinicopathologic features, treatment outcome and evaluation of prognostic factors.
Results:
Out of 33 patients, there were seven cases of undifferentiated pleomorphic sarcoma, four cases each of myxofibrosarcoma, epithelioid sarcoma and malignant peripheral nerve sheath tumour, three cases each of haemangiopericytoma and spindle cell sarcoma, two cases of haemangioendothelioma and a case each of clear cell sarcoma, retroperitoneal sarcoma, angiosarcoma and pleomorphic rhabdomyosarcoma-adult type. The objective response rate was 27%. Most of the patients (67%) received pazopanib in second or subsequent lines of therapy. The majority (70%) were started at a lower dose of 400/600 mg and only 43% of these (10/23) could be escalated to a full dose of 800 mg based on tolerance. On univariate analysis, pazopanib's starting dose didn't predict progression-free survival (PFS)/overall survival (OS)/response rate. At a median duration of follow-up of 18.8 months (range 1.9-150.4 months), the median PFS and median OS were 10.3 months (95% confidence interval (CI): 5.9-14.8) and 17.8 months (95% CI: 10.7-29.3), respectively. 27% of the patients experienced grade ¾ toxicities, 12% required dose modification of pazopanib and 21% needed permanent discontinuation due to toxicity.
Conclusion:
Our study shows that pazopanib is active in rare subtypes of STS.
Insights
Pazopanib shows activity in rare soft tissue sarcoma (STS) subtypes, demonstrating a 27% objective response rate. This study highlights pazopanib
Area of Science:
- Oncology
- Medical Research
- Pharmacology
Background:
- Soft tissue sarcoma (STS) rare histologies are often chemotherapy-resistant with poor outcomes.
- Unclassified STSs and uncommon subtypes represent a significant challenge in unresectable/metastatic disease.
- Limited prospective data exists on pazopanib's efficacy in these rare STS cohorts.
Purpose of the Study:
- To evaluate the safety and efficacy of pazopanib in patients with rare histopathological subtypes of advanced soft tissue sarcoma.
- To assess treatment outcomes, including response rates, progression-free survival, and overall survival.
- To identify potential prognostic factors influencing pazopanib treatment in this patient population.
Main Methods:
- Retrospective analysis of 33 patients with rare STS subtypes treated with pazopanib at two Indian tertiary cancer centers.
- Data collected included clinicopathological features, treatment details, outcomes, and toxicity.
- Patients received pazopanib as per institutional protocol between January 2013 and December 2019 for unresectable/metastatic disease.
Main Results:
- The objective response rate to pazopanib was 27%.
- Median progression-free survival (PFS) was 10.3 months and median overall survival (OS) was 17.8 months.
- Grade 3/4 toxicities occurred in 27% of patients, leading to dose modification in 12% and discontinuation in 21%.
Conclusions:
- Pazopanib demonstrates clinical activity in rare histopathological subtypes of advanced soft tissue sarcoma.
- The drug offers a potential treatment option for patients with previously difficult-to-treat STS.
- Further prospective studies are warranted to confirm these findings and optimize pazopanib use in rare STS.
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