Doxorubicin and trabectedin for recurrent leiomyosarcoma - A case report

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Pharmacology

Background:

• Uterine leiomyosarcoma (LMS) is a rare, aggressive malignancy with limited treatment options.
• Current first-line therapies like doxorubicin or gemcitabine/docetaxel offer modest response rates.
• The combination of doxorubicin and trabectedin is a preferred first-line option based on the LMS-04 study.

Observation:

• A 65-year-old woman with stage 1B uterine LMS experienced recurrence 5 and 9 years after initial treatment (surgery and adjuvant gemcitabine/docetaxel).
• She received second-line therapy with doxorubicin and trabectedin for her second recurrence.
• The patient achieved a partial response after 6 cycles and maintained stable disease with maintenance trabectedin.

Findings:

• The combination of doxorubicin and trabectedin demonstrated significant efficacy in a patient with recurrent uterine LMS.
• This regimen resulted in a partial response and a total of 16 months of progression-free survival, including maintenance therapy and off-treatment follow-up.
• The patient tolerated the treatment well, maintaining stable disease for an extended period.

Implications:

• Doxorubicin plus trabectedin combination chemotherapy represents a viable and potentially effective second-line treatment strategy for recurrent uterine leiomyosarcoma.
• This case highlights the importance of exploring combination regimens for challenging gynecologic cancers.
• Further investigation into this regimen for recurrent LMS is warranted to confirm its efficacy and safety profile.