title: Clinical outcomes and safety with trabectedin therapy in patients with advanced soft tissue sarcomas following failure of prior chemotherapy: results of a worldwide expanded access program study.
abstract: BACKGROUND
  This expanded access program (EAP) was designed to provide trabectedin access for patients with incurable soft tissue sarcoma (STS) following progression of disease with standard therapy. The outcomes of trial participants accrued over approximately 5 years are reported.
  
  
  METHODS
  Adult patients with advanced STS of multiple histologies, including leiomyosarcoma and liposarcoma (L-sarcomas), following relapse or disease progression following standard-of-care chemotherapy, were enrolled. Trabectedin treatment cycles (1.5 mg/m(2), intravenously over 24 h) were repeated q21 days. Objective response, overall survival (OS), and safety were evaluated.
  
  
  RESULTS
  Of 1895 patients enrolled, 807 (43%) had evaluable objective response data, with stable disease reported in 343 (43%) as best response. L-sarcoma patients exhibited longer, OS compared with other histologies [16.2 months (95% confidence interval (CI) 14.1-19.5) versus 8.4 months (95% CI 7.1-10.7)], and a slightly higher objective response rate [6.9% (95% CI 4.8-9.6) versus 4.0% (95% CI 2.1-6.8)]. The median treatment duration was 70 days representing a median of three treatment cycles; 30% of patients received ≥ 6 cycles. Safety and tolerability in this EAP were consistent with prior clinical trial data.
  
  
  CONCLUSIONS
  Results of this EAP are consistent with previous reports of trabectedin, demonstrating disease control despite a low incidence of objective responses in advanced STS patients after failure of standard chemotherapy. CLINICALTRIALS.GOV: NCT00210665.
authors: Department of Medical Oncology, Kootenai Cancer Center, Post Falls, ID 83854, USA.
authors: B L
authors: BL
authors: Samuels
authors: S
authors: S
authors: Chawla
authors: S
authors: S
authors: Patel
authors: M
authors: M
authors: von Mehren
authors: J
authors: J
authors: Hamm
authors: P E
authors: PE
authors: Kaiser
authors: S
authors: S
authors: Schuetze
authors: J
authors: J
authors: Li
authors: A
authors: A
authors: Aymes
authors: G D
authors: GD
authors: Demetri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects; D057176:Compassionate Use Trials / Q000401:mortality / Q000639:trends*; D004149:Dioxoles / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D014943:Global Health / Q000639:trends*; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D000077606:Trabectedin; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D000077606:Trabectedin
keywords: L-sarcoma; expanded access program; objective response rate; overall survival; soft tissue sarcoma; trabectedin