%0 Journal Article
%A D'Ambrosio, Lorenzo
%A Touati, Nathan
%A Blay, Jean-Yves
%A Grignani, Giovanni
%A Flippot, Ronan
%A Czarnecka, Anna M
%A Piperno-Neumann, Sophie
%A Martin-Broto, Javier
%A Sanfilippo, Roberta
%A Katz, Daniela
%A Duffaud, Florence
%A Vincenzi, Bruno
%A Stark, Daniel P
%A Mazzeo, Filomena
%A Tuchscherer, Armin
%A Chevreau, Christine
%A Sherriff, Jenny
%A Estival, Anna
%A Litière, Saskia
%A Sents, Ward
%A Ray-Coquard, Isabelle
%A Tolomeo, Francesco
%A Le Cesne, Axel
%A Rutkowski, Piotr
%A Stacchiotti, Silvia
%A Kasper, Bernd
%A Gelderblom, Hans
%A Gronchi, Alessandro
%A European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group
%T Doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, or doxorubicin alone as a first-line treatment for advanced leiomyosarcoma: A propensity score matching analysis from the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.
%D 2020
%U http://hdl.handle.net/10668/15199
%X The optimal treatment for advanced leiomyosarcoma is still debated. Given histotype-specific prospective controlled data lacking, this study retrospectively evaluated doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone as first-line treatments for advanced/metastatic leiomyosarcoma treated at European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC-STBSG) sites. The inclusion criteria were a confirmed histological diagnosis, treatment between January 2010 and December 2015, measurable disease (Response Evaluation Criteria in Solid Tumors 1.1), an Eastern Cooperative Oncology Group performance status ≤2, and an age ≥ 18 years. The endpoints were progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). PFS was analyzed with methods for interval-censored data. Patients were matched according to their propensity scores, which were estimated with a logistic regression model accounting for histology, grade, age, sex, performance status, tumor site, and tumor extent. Three hundred three patients from 18 EORTC-STBSG sites were identified. One hundred seventeen (39%) received doxorubicin plus dacarbazine, 71 (23%) received doxorubicin plus ifosfamide, and 115 (38%) received doxorubicin. In the 2:1:2 propensity score-matched population (205 patients), the estimated median PFS was 9.2 months (95% confidence interval [CI], 5.2-9.7 months), 8.2 months (95% CI, 5.2-10.1 months), and 4.8 months (95% CI, 2.3-6.0 months) with ORRs of 30.9%, 19.5%, and 25.6% for doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone, respectively. PFS was significantly longer with doxorubicin plus dacarbazine versus doxorubicin (hazard ratio [HR], 0.72; 95% CI, 0.52-0.99). Doxorubicin plus dacarbazine was associated with longer OS (median, 36.8 months; 95% CI, 27.9-47.2 months) in comparison with both doxorubicin plus ifosfamide (median, 21.9 months; 95% CI, 16.7-33.4 months; HR, 0.65; 95% CI, 0.40-1.06) and doxorubicin (median, 30.3 months; 95% CI, 21.0-36.3 months; HR, 0.66; 95% CI, 0.43-0.99). Adjusted analyses retained an effect for PFS but not for OS. None of the factors selected for multivariate analysis had a significant interaction with the received treatment for both PFS and OS. This is the largest retrospective study of first-line treatment for advanced leiomyosarcoma. In the propensity score-matched population, doxorubicin and dacarbazine showed favorable activity in terms of both ORR and PFS and warrants further evaluation in prospective trials.
%K dacarbazine
%K doxorubicin
%K ifosfamide
%K leiomyosarcoma
%K propensity score
%K retrospective study
%K sarcoma
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