A phase II trial of panobinostat in patients with advanced pretreated soft tissue sarcoma. A study from the French Sarcoma Group.
BACKGROUND
Soft tissue sarcomas (STS) are rare tumours for which treatment options are limited in the advanced setting. Histone deacetylase inhibitors have shown activity in preclinical models of STS.


METHODS
We conducted a single-arm, open-label, multicentre phase II study to assess the efficacy and tolerability of panobinostat given orally, 40 mg thrice weekly in patients with advanced pretreated STS. The primary endpoint was the 3-month progression-free rate.


RESULTS
Forty-seven STS patients were enrolled between January 2010 and December 2010. Median age was 59 (range 21-79) years, 22 (47%) patients were males. Panobinostat dose was lowered to 20 mg thrice weekly after nine patients were enrolled, based on the recommendation of an independent safety committee. The most common grade 3/4 adverse events were thrombocytopenia, fatigue, lymphopenia and anaemia. Forty-five patients were evaluable for the primary endpoint. Among them, nine patients (20%, 95% CI (10-35%)) were progression-free at 3 months. No partial response was seen, but 17 patients (36%) had stable disease (SD) as their best response. Six patients were progression-free at 6 months.


CONCLUSIONS
Panobinostat was poorly tolerated at 40 mg thrice a week. Efficacy in unselected advanced STS was limited, although some patients had prolonged SD.
Department of Medicine, Centre Léon Bérard, 28 rue Laennec, 69008 Lyon, France. cassierp@hotmail.com
P A
PA
Cassier
A
A
Lefranc
E Y
EY
Amela
C
C
Chevreau
B N
BN
Bui
A
A
Lecesne
I
I
Ray-Coquard
S
S
Chabaud
N
N
Penel
Y
Y
Berge
J
J
Dômont
A
A
Italiano
F
F
Duffaud
A-C
AC
Cadore
V
V
Polivka
J-Y
JY
Blay
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006877:Hydroxamic Acids / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use*; D007890:Leiomyosarcoma / Q000188:drug therapy / Q000473:pathology; D008080:Liposarcoma / Q000188:drug therapy / Q000473:pathology; D018208:Liposarcoma, Myxoid / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000188:drug therapy / Q000473:pathology; D000077767:Panobinostat; D016879:Salvage Therapy / Q000379:methods; D012509:Sarcoma / Q000188:drug therapy* / Q000473:pathology; D018234:Sarcoma, Alveolar Soft Part / Q000188:drug therapy / Q000473:pathology; D018203:Sarcoma, Endometrial Stromal / Q000188:drug therapy / Q000473:pathology; D013584:Sarcoma, Synovial / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D006877:Hydroxamic Acids; D007211:Indoles; D000077767:Panobinostat