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Smrke A, Frezza AM, Giani C, Somaiah N, Brahmi M, Czarnecka AM, Rutkowski P, Van der Graaf W, Baldi GG, Connolly E, Duffaud F, Huang PH, Gelderblom H, Bhadri V, Grimison P, Mahar A, Stacchiotti S, Jones RL. Systemic treatment of advanced clear cell sarcoma: results from a retrospective international series from the World Sarcoma Network. ESMO Open 2022; 7:100522. [PMID: 35717681 PMCID: PMC9271493 DOI: 10.1016/j.esmoop.2022.100522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Clear cell sarcoma (CCS) is a translocated aggressive malignancy with a high incidence of metastases and poor prognosis. There are few studies describing the activity of systemic therapy in CCS. We report a multi-institutional retrospective study of the outcomes of patients with advanced CCS treated with systemic therapy within the World Sarcoma Network (WSN). Materials and methods Patients with molecularly confirmed locally advanced or metastatic CCS treated with systemic therapy from June 1985 to May 2021 were included. Baseline demographic and treatment information, including response by Response Evaluation Criteria in Solid Tumours (RECIST) 1.1, was retrospectively collected by local investigators. Descriptive statistics were carried out. Results Fifty-five patients from 10 institutions were included. At diagnosis, the median age was 30 (15-73) years and 24% (n = 13/55) had metastatic disease. The median age at diagnosis was 30 (15-73) years. Most primary tumours were at aponeurosis (n = 9/55, 16%) or non-aponeurosis limb sites (n = 17/55, 31%). The most common fusion was EWSR1–ATF1 (n = 24/55, 44%). The median number of systemic therapies was 1 (range 1-7). The best response rate was seen for patients treated with sunitinib (30%, n = 3/10), with a median progression-free survival of 4 [95% confidence interval (CI) 1-7] months. The median overall survival for patients with advanced/metastatic disease was 15 months (95% CI 3-27 months). Conclusions Soft tissue sarcoma-type systemic therapies have limited benefit in advanced CCS and response rate was poor. International, multicentre prospective translational studies are required to identify new treatments for this ultra-rare subtype, and access to early clinical trial enrolment remains key for patients with CCS. This is the largest reported series of advanced CCS patients treated with systemic therapy. The activity of sarcoma-type systemic therapy is poor and modest responses were seen only with sunitinib. Effective therapies are needed to improve outcomes for patients with this ultra-rare sarcoma type.
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Affiliation(s)
- A Smrke
- The Royal Marsden Hospital NHS Foundation Trust, London, UK; BC Cancer, Vancouver, Canada
| | - A M Frezza
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C Giani
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - N Somaiah
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M Brahmi
- Centre Leon Berard, Lyon, France
| | - A M Czarnecka
- Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - P Rutkowski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | | | - G G Baldi
- Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - E Connolly
- Chris O'Brien Lifehouse, Camperdown, Australia
| | - F Duffaud
- La Timone Hospital and Aix-Marseille University (AMU), Marseilles, France
| | - P H Huang
- Institute of Cancer Research, London, UK
| | - H Gelderblom
- Leiden University Medical Center, Leiden, The Netherlands
| | - V Bhadri
- Chris O'Brien Lifehouse, Camperdown, Australia
| | - P Grimison
- Chris O'Brien Lifehouse, Camperdown, Australia
| | - A Mahar
- Royal Prince Alfred Hospital, Camperdown, Australia
| | - S Stacchiotti
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - R L Jones
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.
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Palassini E, Mir O, Grignani G, Vincenzi B, Gelderblom H, Sebio A, Valverde C, Baldi GG, Brunello A, Cardellino GG, Marrari A, Badalamenti G, Martin-Broto J, Ferraresi V, Libertini M, Turano S, Gataa I, Collini P, Tos APD, Gennaro M, Bini F, Provenzano S, Vullo SL, Mariani L, Le Cesne A, Casali PG. Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses. Breast Cancer Res Treat 2022; 192:603-610. [PMID: 35150367 DOI: 10.1007/s10549-022-06524-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed at investigating outcome of systemic treatments in advanced breast PT. METHODS All cases of advanced breast PT treated with systemic treatments from 1999 to 2019, in one of the referral sarcoma centers involved in the study, were retrospectively reviewed. RESULTS 56 female patients were identified. Median age was 52 (range of 25-76) years. Patients received a median number of 2 systemic treatments (range of 1-4). Best responses according to RECIST were 1 (3.7%) CR, 11 (40.7%) PR, 6 (22.2%) SD, 9 (33.3%) PD with anthracyclines plus ifosfamide (AI); 2 (16.7%) PR, 4 (33.3%) SD, 6 (50.0%) PD with anthracycline alone; 3 (18.8%) PR, 4 (25.0%) SD, 9 (56.3%) PD with high-dose ifosfamide given as a continuous infusion (HD-IFX); 3 (20.0%) SD, 12 (80.0%) PD with a gemcitabine-based regimen (with 2 patients not evaluable); 1 (8.3%) PR, 2 (16.7%) SD, 9 (75.0%) PD with trabectedin (with 1 patient not evaluable); 1 (16.7%) PR, 1 (16.7%) SD, 4 (66.7%) PD with tyrosine-kinase inhibitors (TKI). The median PFS were 5.7 (IQR 2.5-9.1) months with AI; 3.2 (IQR 2.2-5.0) months with anthracycline alone; 3.4 (IQR 1.4-6.7) months with HD-IFX; 2.1 (IQR 1.4-5.2) months with gemcitabine-based chemotherapy; 1.8 (IQR 0.7-6.6) months with trabectedin; 3.4 (IQR 3.1-3.8) months with TKI. With a median follow-up of 35.3 (IQR 17.6-66.9) months, OS from the start of first-line systemic treatment was 15.2 (IQR 7.6-39.6) months. CONCLUSION In this series of advanced PT (to our knowledge, the largest reported so far), AI was associated with a high rate of responses, however, with a median PFS of 5.7 months. Other systemic treatments were poorly active.
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Affiliation(s)
- E Palassini
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - O Mir
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - G Grignani
- Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - B Vincenzi
- Department of Medical Oncology, Campus Biomedico University, Rome, Italy
| | - H Gelderblom
- Department of Medical Oncology, LUMC - Leiden University Medical Center, Leiden, Netherlands
| | - A Sebio
- Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Valverde
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - G G Baldi
- Department of Medical Oncology, Ospedale "Santo Stefano", Prato, Italy
| | - A Brunello
- Department of Oncology, Oncology 1 Unit, Istituto Oncologico Veneto - IOV, IRCCS, Padua, Italy
| | - G G Cardellino
- Department of Oncology, Presidio "S. Maria della Misericordia" di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - A Marrari
- Department of Oncology and Hematology, Humanitas Cancer Center Rozzano, Rozzano, Milan, Italy
| | - G Badalamenti
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - J Martin-Broto
- Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - V Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Libertini
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - S Turano
- Department of Oncology, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - I Gataa
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - P Collini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A P Dei Tos
- Department of Pathology, Azienda Ospedaliera Università Padova, Padua, Italy
| | - M Gennaro
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Bini
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Lo Vullo
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Le Cesne
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - P G Casali
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Stacchiotti S, Tortoreto M, Baldi GG, Grignani G, Toss A, Badalamenti G, Cominetti D, Morosi C, Dei Tos AP, Festinese F, Fumagalli E, Provenzano S, Gronchi A, Pennacchioli E, Negri T, Dagrada GP, Spagnuolo RD, Pilotti S, Casali PG, Zaffaroni N. Preclinical and clinical evidence of activity of pazopanib in solitary fibrous tumour. Eur J Cancer 2014; 50:3021-8. [PMID: 25269954 DOI: 10.1016/j.ejca.2014.09.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/10/2014] [Accepted: 09/08/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND To explore the activity of pazopanib in solitary fibrous tumour (SFT). PATIENTS AND METHODS In a preclinical study, we compared the activity of pazopanib, sorafenib, sunitinib, regorafenib, axitinib and bevacizumab in a dedifferentiated-SFT (DSFT) xenotransplanted into Severe Combined Immunodeficiency (SCID) mice. Antiangiogenics were administered at their reported optimal doses when mean tumour volume (TV) was 80 mm(3). Drug activity was assessed as TV inhibition percentage (TVI%). From May 2012, six consecutive patients with advanced SFT received pazopanib, on a national name-based programme. In one case sunitinib was administered after pazopanib failure. RESULTS In the xenograft model, pazopanib showed the lowest antitumour activity (21%TVI), while regorafenib was the most active (95%TVI). Sorafenib, bevacizumab, sunitinib were markedly active (78/70/65%TVI). Axitinib was marginally active (51%TVI). In the retrospective case-series, three patients carried malignant-SFT (MSFT), three DSFT. Best Response Evaluation Criteria in Solid Tumour (RECIST) responses were: three stable disease (SD), all MSFT, three progressive disease (PD), all DSFT, corresponding to one partial response (PR), two SD, three PD by Choi criteria. Median-progression-free survival was 3 months (range 1-15). In one patient, sunitinib was started after pazopanib failure, with a response. CONCLUSIONS In dedifferentiated-SFT xenograft pazopanib induced a marginal antitumour activity, while regorafenib appeared the most active and promising agent. When administered in patients, pazopanib showed a modest activity in terms of tumour growth stabilisation, observed only in non-dedifferentiated cases.
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Affiliation(s)
- S Stacchiotti
- Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - M Tortoreto
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - G G Baldi
- Medical Oncology Unit 'Sandro Pitigliani', S. Stefano Civil Hospital, Prato, Italy
| | - G Grignani
- Medical Oncology, IRCCS - Istituto di Candiolo, Candiolo, Italy
| | - A Toss
- Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - G Badalamenti
- Department of Oncology, University Hospital of Palermo, Palermo, Italy
| | - D Cominetti
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A P Dei Tos
- Department of Anatomic Pathology, General Hospital of Treviso, Treviso, Italy
| | - F Festinese
- Pharmacy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Fumagalli
- Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Provenzano
- Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A Gronchi
- Melanoma and Sarcoma Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Pennacchioli
- Melanoma and Sarcoma, Surgery Department, Istituto Europeo di Oncologia, Milan, Italy
| | - T Negri
- Laboratory of Experimental Molecular Pathology, Department of Diagnostic Pathology and Laboratory, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - G P Dagrada
- Laboratory of Experimental Molecular Pathology, Department of Diagnostic Pathology and Laboratory, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - R D Spagnuolo
- Laboratory of Experimental Molecular Pathology, Department of Diagnostic Pathology and Laboratory, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Pilotti
- Laboratory of Experimental Molecular Pathology, Department of Diagnostic Pathology and Laboratory, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - P G Casali
- Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - N Zaffaroni
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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