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Updated: Jun 27, 2025
A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
Predicting Trabectedin Efficacy in Soft Tissue Sarcoma: Inflammatory Biomarker Analysis
Toru Imai1, Yuki Kojima2, Tatsunori Shimoi1
1Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Background/Aim:
Trabectedin is used as a treatment for advanced-stage soft tissue sarcomas (STSs), particularly liposarcoma and leiomyosarcoma. Aside from its direct effect on tumor cells, trabectedin can affect the immune system in the tumor microenvironment. This study aimed to evaluate whether inflammatory biomarkers predict trabectedin efficacy in STSs.
Patients And Methods:
We retrospectively reviewed the clinical features and outcomes of patients with STS treated with trabectedin at our institution between 2016 and 2020. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI=neutrophil × monocyte/lymphocyte) were calculated based on the blood samples obtained prior to trabectedin treatment initiation. Analyses of overall survival (OS) and progression-free survival (PFS) were performed according to various factors.
Results:
Of the 101 patients identified, 54 had L-sarcoma (leiomyosarcoma: 30; liposarcoma: 24), and 47 had other types of STSs. Elevated SIRI, NLR, PLR, LMR, and C-reactive protein (CRP) were associated with worse PFS (p<0.001, p=0.008, p=0.027, p=0.013, and p<0.001, respectively) according to the results of the univariate analysis. Multivariate analysis showed that elevated SIRI, other histology, and CRP were associated with poor PFS (p=0.007, p=0.008, and p=0.029, respectively). In addition, the multivariate analysis of OS showed that SIRI was an independent prognostic factor (hazard ratio=2.16, p=0.006).
Conclusion:
Pretreatment SIRI can be considered a biomarker for the prognostic prediction of patients with STS treated with trabectedin.
Insights
The systemic inflammation response index (SIRI) can predict trabectedin treatment effectiveness in soft tissue sarcomas (STSs). Elevated pretreatment SIRI indicates a poorer prognosis for patients with STS receiving trabectedin therapy.
Area of Science:
- Oncology
- Immunology
- Biomarker Discovery
Background:
- Trabectedin is a key treatment for advanced soft tissue sarcomas (STSs), including liposarcoma and leiomyosarcoma.
- Beyond direct anti-tumor effects, trabectedin influences the tumor microenvironment's immune response.
- Identifying predictive biomarkers for trabectedin efficacy is crucial for optimizing patient outcomes.
Purpose of the Study:
- To investigate the predictive value of inflammatory biomarkers for trabectedin efficacy in STS patients.
- To assess the association between pretreatment inflammatory markers and treatment outcomes (PFS and OS).
Main Methods:
- Retrospective analysis of 101 STS patients treated with trabectedin (2016-2020).
- Calculation of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI) from pre-treatment blood samples.
- Statistical analysis of overall survival (OS) and progression-free survival (PFS) in relation to biomarkers and clinical factors.
Main Results:
- Elevated SIRI, NLR, PLR, LMR, and C-reactive protein (CRP) were associated with worse progression-free survival (PFS) in univariate analysis.
- Multivariate analysis confirmed elevated SIRI, other histology, and CRP as predictors of poor PFS.
- SIRI emerged as an independent prognostic factor for overall survival (OS) in multivariate analysis.
Conclusions:
- Pretreatment SIRI is a valuable biomarker for predicting prognosis in STS patients undergoing trabectedin therapy.
- SIRI can aid in stratifying patients and personalizing treatment strategies for STSs.
