Frontiers in Oncology (Dec 2022)

Transcription regulators and ultra-rare and other rare translocation-related sarcomas treated with trabectedin: A proof of principle from a post-hoc analysis

  • Emanuela Palmerini,
  • Roberta Sanfilippo,
  • Giovanni Grignani,
  • Angela Buonadonna,
  • Antonella Romanini,
  • Giuseppe Badalamenti,
  • Virginia Ferraresi,
  • Bruno Vincenzi,
  • Alessandro Comandone,
  • Antonio Pizzolorusso,
  • Antonella Brunello,
  • Fabio Gelsomino,
  • Tommaso De Pas,
  • Toni Ibrahim,
  • Lorena Gurrieri,
  • Federica Grosso,
  • Francesca Zanelli,
  • Maria Abbondanza Pantaleo,
  • Laura Milesi,
  • Libero Ciuffreda,
  • Vittorio Ferrari,
  • Emanuela Marchesi,
  • Irene Quattrini,
  • Alberto Righi,
  • Elisabetta Setola,
  • Elisa Carretta,
  • Paolo G. Casali,
  • Paolo G. Casali,
  • Piero Picci,
  • Stefano Ferrari

DOI
https://doi.org/10.3389/fonc.2022.1042479
Journal volume & issue
Vol. 12

Abstract

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BackgroundAmong sarcomas, which are rare cancers with an incidence of <6 per 100.000/year cases, ultra-rare sarcomas have an incidence of approximately ≤1/1,000,000/year cases and altogether account for ~20% of all soft tissue sarcomas (STS) and bone sarcomas. The Italian Sarcoma Group has recently performed a non-interventional, retrospective TrObs study with data from 512 anthracycline-pretreated patients with advanced multiple STS histologies and treated with trabectedin (Palmerini, Cancers 2021; ClinicalTrials.gov Identifier: NCT02793050).MethodsA post-hoc analysis of case series to evaluate the efficacy and safety of trabectedin on patients with ultra-rare and other rare translocation-related sarcomas included in TrObs study was performed. Main outcomes comprised investigator-assessed overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and safety.ResultsThirty-six patients (18 women) with ultra-rare and other rare sarcoma and a median age of 53.0 years (range: 22-81) were included. Most patients had solitary fibrous tumor (SFT; n=11) followed by epithelioid sarcoma (n=5), malignant peripheral nerve sheath tumor (MPNST; n=4), extraskeletal myxoid chondrosarcoma (EMC; n=3), desmoplastic small round cell tumor (DSRCT; n=3), and alveolar soft part sarcoma (ASPS), rhabdomyosarcoma and clear cell sarcoma (n=2 each). Thirty-five patients had metastatic disease and 23 patients received trabectedin as a second-line treatment. Among 35 patients evaluable for response, two patients with SFT and ASPS had a partial response and one patient with DSRCT obtained a complete response, reaching an ORR of 8.6% (95% CI: 2.8-23.4%). Among patients with an ORR, 6-months PFS was 100% in patients with ASPS, 45.7% in patients with SFT and 33.3% in those with DSRCT. Two patients with epithelioid sarcoma and myoepithelioma had disease stabilization lasting >24 months. Nine patients had at least one grade 3/4 adverse event, mostly being bone marrow toxicity (n=6).ConclusionsTrabectedin has some anti-tumor activity in some ultra-rare and other rare sarcomas, particularly translocation-related sarcomas, with the well-known manageable safety profile.

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