Treatment patterns and survival in an exhaustive French cohort of pazopanib-eligible patients with metastatic soft tissue sarcoma (STS).
BACKGROUND
The French EMS study prospectively collected exhaustive data from STS patients diagnosed in the Rhone-Alpes region from 2005 to 07.


METHODS
The database included diagnosis/histology, surgery, radiotherapy, systemic treatments and treatment response. Treatment patterns and outcomes of patients with metastatic disease, excluding adipocytic sarcoma and GIST were analyzed.


RESULTS
Of 888 total patients, 145 were included based on having metastatic disease and appropriate subtypes. All patients received treatment with systemic therapy being most common (74%, n = 107), followed by radiotherapy (30%, n = 44) and surgery (23%, n = 33). Doxorubicin, alone or in combination, was the most common first line systemic therapy (65%, n = 46). Drugs without license in sarcoma were used in 38-83% of treatments depending on treatment line. 24% of frontline patients demonstrated an objective response, decreasing to 11% objective responses in second line but no responses were documented beyond second line, with median PFS declining with each additional line. Median PFS also declined in patients receiving surgery compared to those receiving no surgery (8-15 m vs 5 m). Median OS from metastatic diagnosis for patients receiving systemic therapy was double that of patients without systemic treatment (24 m vs 12 m, p = 0.007).


CONCLUSIONS
Outcomes in this population were poor and declined with successive treatment. However, results suggest that further anticancer therapies in recurrent sarcoma might be beneficial.
Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France. isabelle.ray-coquard@lyon.unicancer.fr.|Service D'oncologie Médicale, Centre Léon Bérard, 28, rue Laennec, 69008, Lyon, France. isabelle.ray-coquard@lyon.unicancer.fr.
Isabelle
I
Ray-Coquard
Institut de Cancérologie de la Loire Lucien Neuwirth, 108 Bis av. Albert Raimond, 42270, Saint-Priest en Jarez, France.
Olivier
O
Collard
Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France.
Françoise
F
Ducimetiere
CHU de Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France.
Mathieu
M
Laramas
Stat Process, 52 Boulevard Sébastopol, 75003, Paris, France.
Florence
F
Mercier
Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France.
Nadine
N
Ladarre
Novartis, Park View, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK.
Stephanie
S
Manson
Novartis, 2-4, rue Lionel Terray, Boite postale 308, F-92506, Rueil-Malmaison Cedex, France.
Bertrand
B
Tehard
Centre Marie Curie, 137 Avenue de Romans, 26000, Valence, France.
Sébastien
S
Clippe
Service de Radiothérapie, Centre Hospitalier de Roanne, 28 Rue de Charlieu, 42300, Roanne, France.
Jean-Philippe
JP
Suchaud
Centre Hospitalier Annecy-Genevois, 1 Avenue de l'Hôpital, 74370, Metz-Tessy, France.
Laetitia
L
Stefani
Centre Léon-Bérard, University Claude Bernard Lyon I, 28 rue Laennec, 69008, Lyon, France.
Jean-Yves
JY
Blay
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007191:Indazoles; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use; D012509:Sarcoma / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D013449:Sulfonamides / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D007191:Indazoles; D011743:Pyrimidines; D013449:Sulfonamides; C516667:pazopanib
Chemotherapy; Database; Metastatic; Sarcoma; Survival; Treatment