Open Access

Trabectedin in metastatic soft tissue sarcomas: Role of pretreatment and age

  • Authors:
    • Mathias Hoiczyk
    • Florian Grabellus
    • Lars Podleska
    • Marit Ahrens
    • Benjamin Schwindenhammer
    • Georg Taeger
    • Christoph Pöttgen
    • Martin Schuler
    • Sebastian Bauer
  • View Affiliations

  • Published online on: May 2, 2013     https://doi.org/10.3892/ijo.2013.1928
  • Pages: 23-28
  • Copyright: © Hoiczyk et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 3.0].

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Abstract

Trabectedin has mostly been studied in metastatic leiomyosarcoma and liposarcomas. Only limited data are available in other sarcoma subtypes, heavily pretreated and elderly patients. We retrospectively analyzed 101 consecutive sarcoma patients treated with trabectedin at our center. We recorded progression-free survival (PFS), clinical benefit rate (CBR, defined as complete or partial response or stable disease for at least 6 weeks) and toxicity. Covariates were sarcoma subtype, age and pretreatment. On average, trabectedin was administered for 2nd relapse/progression (range 1st to 12th line). A median of 2 cycles and a dose of 1.5 mg/m2 (range 1-21 cycles; 1.3-1.5 mg/m2) was administered. The median PFS under treatment with trabectedin was 2.1 months in the overall population. Different clinical outcomes were observed with respect to sarcoma subtypes: in patients with L-sarcoma [defined as leiosarcoma and liposarcoma (n=25)] the CBR was 55%. Notably, long lasting remissions were even observed in 7th-line treatment. In contrast, the majority of patients with non-L-sarcomas quickly progressed (median PFS 1.6 months). Nevertheless, a CBR of 34% was achieved, including long-lasting disease stabilization in subtypes such as rhabdomyosarcoma. Patients treated with trabectedin at 1st or 2nd line (n=16) achieved an improved PFS (median 5.7 months, range) and a CBR of 59%. No differences in terms of toxicity or efficacy were observed between patients older than 65 years (n=23) and younger patients (n=78). In this non-trial setting, port-associated complications were more frequent (14%) with trabectedin compared to other continuous infusion protocols administered at our outpatient therapy center. The majority of patients with relapsing L-sarcomas and a substantial fraction of patients with non-L-sarcomas derive a clinically meaningful benefit from trabectedin. Outpatient treatment is well tolerated also in elderly and heavily pretreated patients. Port-associated complications were observed at an unusually high rate. This suggests a drug-specific local toxicity that merits further investigation.
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July 2013
Volume 43 Issue 1

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Hoiczyk M, Grabellus F, Podleska L, Ahrens M, Schwindenhammer B, Taeger G, Pöttgen C, Schuler M and Bauer S: Trabectedin in metastatic soft tissue sarcomas: Role of pretreatment and age. Int J Oncol 43: 23-28, 2013
APA
Hoiczyk, M., Grabellus, F., Podleska, L., Ahrens, M., Schwindenhammer, B., Taeger, G. ... Bauer, S. (2013). Trabectedin in metastatic soft tissue sarcomas: Role of pretreatment and age. International Journal of Oncology, 43, 23-28. https://doi.org/10.3892/ijo.2013.1928
MLA
Hoiczyk, M., Grabellus, F., Podleska, L., Ahrens, M., Schwindenhammer, B., Taeger, G., Pöttgen, C., Schuler, M., Bauer, S."Trabectedin in metastatic soft tissue sarcomas: Role of pretreatment and age". International Journal of Oncology 43.1 (2013): 23-28.
Chicago
Hoiczyk, M., Grabellus, F., Podleska, L., Ahrens, M., Schwindenhammer, B., Taeger, G., Pöttgen, C., Schuler, M., Bauer, S."Trabectedin in metastatic soft tissue sarcomas: Role of pretreatment and age". International Journal of Oncology 43, no. 1 (2013): 23-28. https://doi.org/10.3892/ijo.2013.1928