title: 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.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Medical 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.
  
  
  RESULTS
  A 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).
  
  
  CONCLUSIONS
  Wide 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.
authors.affiliation: Dana-Farber Cancer Institute, Ludwig Center at Harvard, 450 Brookline Avenue, Boston, MA, 02215, USA. mwagnermd@gmail.com.|MD Anderson Cancer Center, Houston, TX, 77030, USA. mwagnermd@gmail.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wagner
authors.affiliation: Dana-Farber Cancer Institute, Ludwig Center at Harvard, 450 Brookline Avenue, Boston, MA, 02215, USA. amodleo@gmail.com.|North Shore-LIJ Health System, Manhasset, NY, 10030, USA. amodleo@gmail.com.
authors.forename: Leo Ismaila
authors.initials: LI
authors.lastname: Amodu
authors.affiliation: Analysis Group, Inc, Boston, MA, 02199, USA. mei.duh@analysisgroup.com.
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.affiliation: Analysis Group, Inc, Boston, MA, 02199, USA. caroline.korves@analysisgroup.com.
authors.forename: Caroline
authors.initials: C
authors.lastname: Korves
authors.affiliation: Analysis Group, Inc, Boston, MA, 02199, USA. fsolleza@mathematica-mpr.com.
authors.forename: Franco
authors.initials: F
authors.lastname: Solleza
authors.affiliation: Value Evidence and Outcomes, GlaxoSmithKline, Uxbridge, UB11 1BT, UK. stephanie.manson@novartis.com.|Novartis Pharmaceuticals, Uxbridge, UB11 1BT, UK. stephanie.manson@novartis.com.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Manson
authors.affiliation: Value Evidence and Outcomes, GlaxoSmithKline, Uxbridge, UB11 1BT, UK. jose-r.diaz@novartis.com.|Novartis Pharmaceuticals, Uxbridge, UB11 1BT, UK. jose-r.diaz@novartis.com.
authors.forename: José
authors.initials: J
authors.lastname: Diaz
authors.affiliation: Value Evidence and Outcomes, GlaxoSmithKline, Collegeville, PA, 19426, USA. nearymp22372@yahoo.com.|Novartis Pharmaceutical Corporation, East Hanover, NJ, 07936, USA. nearymp22372@yahoo.com.
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Neary
authors.affiliation: Dana-Farber Cancer Institute, Ludwig Center at Harvard, 450 Brookline Avenue, Boston, MA, 02215, USA. george_demetri@dfci.harvard.edu.
authors.forename: George D
authors.initials: GD
authors.lastname: Demetri
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents