A retrospective chart review of drug treatment patterns and clinical outcomes among patients with metastatic or recurrent soft tissue sarcoma refractory to one or more prior chemotherapy treatments.

Michael J Wagner,Leo Ismaila Amodu,José Diaz,Mei Sheng Duh,Maureen P Neary,Franco Solleza,George D Demetri,Caroline Korves,Stephanie C Manson

doi:10.1186/s12885-015-1182-4

Abstract

BackgroundLimited clinical data on real-world practice patterns are available for patients with metastatic/relapsed soft tissue sarcomas (STS). The primary objective of this study was to evaluate treatment patterns in patients with metastatic/relapsed STS following failure of prior chemotherapy by examining data collected from 2000 to 2011 from a major tertiary academic cancer center in the United States.MethodsMedical records, including community-based referral records, from a tertiary cancer center for adult patients with metastatic/relapsed STS with confirmed disease progression who commenced second-line treatment between January 1, 2000 and February 4, 2011, and with at least 3 months of follow-up data following second-line treatment initiation, were retrospectively reviewed. Overall survival, time to progression, and clinician-reported tumor response were collected.ResultsA total of 99 patients (leiomyosarcoma, n = 48; synovial cell sarcoma, n = 7; liposarcoma, n = 5; or other histological subtypes, n = 39) received an average of four lines of treatment (maximum of 10). No consistent or dominant regimens were used in each treatment line beyond the second line. Median second-line treatment duration was 4.1 months (95% confidence interval, 3.0–5.0). Overall, 72 of 99 patients (73%) discontinued second-line treatment due to progressive disease. Median progression-free survival from initiation of second-line treatment varied across regimens from 2.0 to 6.6 months (overall median, 5.4 months).ConclusionsWide variations in treatment were evident, with no single standard of care for patients with metastatic/relapsed STS. Most patients discontinued second-line treatment due to progressive disease, often receiving additional systemic therapy with other drugs. These data suggest a high unmet need for more efficacious treatment options and improved data collection to guide practice among patients with relapsed/refractory STS.

Highlights

Limited clinical data on real-world practice patterns are available for patients with metastatic/relapsed soft tissue sarcomas (STS)
Individual patient records were retrospectively reviewed in a sequential manner from this prospectively collected Sarcoma Center consented registry, based upon a diagnosis of metastatic/ relapsed STS in patients aged 18 years or older who had received at least two lines of systemic therapies with initiation of second-line systemic therapy between January 1, 2000 and February 4, 2011
Of the 99 patients with metastatic/relapsed STS included in this analysis, the mean age was 51.9 years and 62% were women (Table 1)

Summary

Introduction

Limited clinical data on real-world practice patterns are available for patients with metastatic/relapsed soft tissue sarcomas (STS). The primary objective of this study was to evaluate treatment patterns in patients with metastatic/relapsed STS following failure of prior chemotherapy by examining data collected from 2000 to 2011 from a major tertiary academic cancer center in the United States. Soft tissue sarcomas (STS) are rare cancers of mesenchymal cell origin that include more than 50 histological subtypes, as well as many more molecularly distinct entities [1,2]. The American Cancer Society estimated that 11 280 new cases of STS were diagnosed and 3900 patients died in 2012 in the United States [4]. Survival estimates for primary localized STS depend on many factors, including anatomic location and tumor grade [1]. Approximately 50% of patients with STS will develop recurrences or metastatic disease [5,6]

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