title: Prolonged disease stability with trabectedin in a heavily pretreated elderly patient with metastatic leiomyosarcoma of the thigh and renal failure: a case report and review of the literature.
abstract: Leiomyosarcoma represents about 24% of all soft tissue sarcomas and can originate from retroperitoneum, uterus, or extremities. Adequate local control may be achieved with surgery and radiotherapy. In the presence of unresectable metastases either doxorubicin- or gemcitabine-based chemotherapy is the standard of treatment. Nevertheless, prognosis remains poor regardless of the selected chemotherapy regimen, and new effective therapeutic agents for patients with advanced leiomyosarcoma are needed. Trabectedin, a promising new DNA-damaging agent with a mechanism of action that is different from that of traditional alkylating agents, is approved in Europe for the treatment of patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents and in combination with pegylated liposomal doxorubicin (PLD) for the treatment of patients with relapsed platinum-sensitive ovarian cancer. We present a case of a 76-year-old patient with progressive metastatic lung lesions from a previously resected primary leiomyosarcoma of the thigh and moderate renal failure, who achieved 17 months of disease stability during third-line treatment with trabectedin. Trabectedin was not associated with any cumulative toxicity and was consistently well tolerated for a total of 22 treatment cycles. Current evidence on trabectedin is also presented.
authors.affiliation: Medical Oncology Unit, Institute for Cancer Research and Treatment, Fondazione del Piemonte per l' Oncologia Candiolo, Turin, Italy. danilo.galizia@ircc.it
authors.forename: Danilo
authors.initials: D
authors.lastname: Galizia
authors.forename: Erica
authors.initials: E
authors.lastname: Palesandro
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Nuzzo
authors.forename: Ymera
authors.initials: Y
authors.lastname: Pignochino
authors.forename: Sandra
authors.initials: S
authors.lastname: Aliberti
authors.forename: Massimo
authors.initials: M
authors.lastname: Aglietta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grignani
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D004149:Dioxoles / Q000627:therapeutic use*; D018450:Disease Progression; D006801:Humans; D007890:Leiomyosarcoma / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis; D016879:Salvage Therapy; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D000077606:Trabectedin; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D000077606:Trabectedin