RT Journal Article
T1 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.
A1 D'Ambrosio, Lorenzo
A1 Touati, Nathan
A1 Blay, Jean-Yves
A1 Grignani, Giovanni
A1 Flippot, Ronan
A1 Czarnecka, Anna M
A1 Piperno-Neumann, Sophie
A1 Martin-Broto, Javier
A1 Sanfilippo, Roberta
A1 Katz, Daniela
A1 Duffaud, Florence
A1 Vincenzi, Bruno
A1 Stark, Daniel P
A1 Mazzeo, Filomena
A1 Tuchscherer, Armin
A1 Chevreau, Christine
A1 Sherriff, Jenny
A1 Estival, Anna
A1 Litière, Saskia
A1 Sents, Ward
A1 Ray-Coquard, Isabelle
A1 Tolomeo, Francesco
A1 Le Cesne, Axel
A1 Rutkowski, Piotr
A1 Stacchiotti, Silvia
A1 Kasper, Bernd
A1 Gelderblom, Hans
A1 Gronchi, Alessandro
A1 European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group, 
K1 dacarbazine
K1 doxorubicin
K1 ifosfamide
K1 leiomyosarcoma
K1 propensity score
K1 retrospective study
K1 sarcoma
AB 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.
YR 2020
FD 2020-03-04
LK http://hdl.handle.net/10668/15199
UL http://hdl.handle.net/10668/15199
LA en
DS RISalud
RD Apr 19, 2025