Complete pathological response to neoadjuvant treatment is associated with better survival outcomes in patients with soft tissue sarcoma: Results of a retrospective multicenter study

Bonvalot, Sylvie; Wunder, Jay S.; Gronchi, Alessandro; Martin‐Broto, Javier; Turcotte, Robert; Rastrelli, Marco; Pápai, Zsuzsanna; Radaelli, Stefano; Lindner, Lars H.; Shumelinsky, Felix; Cubillo, Antonio; Rutkowski, Piotr; Demaire, Clémentine; Strens, D; Nalbantov, Georgi

doi:10.1016/j.ejso.2021.02.024

Cited by 41 publications

(32 citation statements)

References 28 publications

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“…While their study did not show a survival benefit, it did show that NAC was well-tolerated and associated with improved primary wound closure. More recent studies have demonstrated potential survival benefits in patients who achieve a pCR from NAC treatment of soft-tissue sarcomas [24]. While this previous study was also not exclusively examining breast angiosarcoma patients, it demonstrates that favorable response rates after NAC may portend improved OS.…”

Section: Discussionmentioning

confidence: 71%

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Kronenfeld

Crystal

Ryon

et al. 2021

Cancers

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Background: The optimal management of primary angiosarcoma (PAS) and radiation-associated angiosarcoma (RAAS) of the breast remains undefined. Available data show persistently poor survival outcomes following treatment with surgery or chemotherapy alone. The objective of this study was to evaluate long-term outcomes in patients treated with multimodality therapy. Methods: Patients diagnosed with stage I–III PAS or RAAS of the breast were identified from our local tumor registry (2010–2020). Patient demographics, tumor characteristics, and treatment were collected. Primary outcomes were local recurrence (LR), distant recurrence (DR), and median overall survival (OS). A secondary outcome was pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC). Mann–Whitney U, chi-squared, or Fisher exact tests were used to analyze data. Kaplan–Meier curves compared OS for PAS and RAAS. Results: Twenty-two patients met inclusion criteria, including 11 (50%) with RAAS and 11 (50%) with PAS. Compared to PAS patients, RAAS patients were older and had more comorbidities. For RAAS patients, median time from radiation to diagnosis was 6 years (IQR: 5–11). RAAS patients were more likely to have a pCR to NAC (40% vs. 20%, p = 0.72). RAAS patients had a higher LR rate (43% vs. 38%, p = 0.83), and PAS patients were more likely to develop a DR (38% vs. 0%, p = 0.07). Median OS was 81 months in PAS patients and 90 months in RAAS patients (p = 1.00). Discussion: Long-term survival can be achieved in patients with PAS and RAAS who undergo multimodality treatment. NAC can result in pCR. The long-term clinical implications of pCR warrant further investigation.

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Section: Discussionmentioning

confidence: 71%

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Kronenfeld

Crystal

Ryon

et al. 2021

Cancers

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“…Pathologic response to neoadjuvant therapy had been investigated in RTOG 9514, where 27% of patients who received interdigitated chemotherapy and radiation had a pathologic complete response (pCR) (39). Recent data has shown pCR such as necrosis and/or fibrosis have led to improved overall and distant recurrence-free survival (19,37,(39)(40)(41). Seldon et al, retrospectively reviewed 79 patients who received neoadjuvant radiation, chemotherapy or chemoradiation and showed that chemoradiation was associated with higher rates of pCR, as defined by ≥90% necrosis.…”

Section: Discussionmentioning

confidence: 99%

“… 39 Recent data have shown pCR such as necrosis and/or fibrosis has led to improved OS and distant recurrence-free survival. 19 , 37 , 39 , 40 , 41 Seldon et al retrospectively reviewed 79 patients who received neoadjuvant irradiation, chemotherapy, or chemoradiation, and showed that chemoradiation was associated with higher rates of pCR, as defined by ≥90% necrosis. 40 Pathologic complete response was also associated with improved OS (100% vs 81.2%, P = .18).…”

Section: Discussionmentioning

confidence: 99%

Is 5 the New 25? Long-Term Oncologic Outcomes From a Phase II, Prospective, 5-Fraction Preoperative Radiation Therapy Trial in Patients With Localized Soft Tissue Sarcoma

Bedi¹,

Singh²,

Charlson³

et al. 2022

Advances in Radiation Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Morphological response is closely related to survival in soft-tissue sarcoma. Patients with soft-tissue sarcoma who receive a complete pathological response upon neoadjuvant oncological treatment have a significantly better prognosis [41]. In MLS, morphological transitions, such as lipoblastic or adipocytic maturation, have been observed as a result of neoadjuvant treatment [42,43].…”

Section: Discussionmentioning

confidence: 99%

Different HSP90 Inhibitors Exert Divergent Effect on Myxoid Liposarcoma In Vitro and In Vivo

et al. 2022

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The therapeutic options for patients with relapsed or metastatic myxoid liposarcoma (MLS) remain scarce and there is currently no targeted therapy available. Inhibition of the HSP90 family of chaperones has been suggested as a possible therapeutic option for patients with MLS. However, the clinical effect of different HSP90 inhibitors vary considerably and no comparative study in MLS has been performed. Here, we evaluated the effects of the HSP90 inhibitors 17-DMAG, AUY922 and STA-9090 on MLS cell lines and in an MLS patient-derived xenograft (PDX) model. Albeit all drugs inhibited in vitro growth of MLS cell lines, the in vivo responses were discrepant. Whereas 17-DMAG inhibited tumor growth, AUY922 surprisingly led to increased tumor growth and a more aggressive morphological phenotype. In vitro, 17-DMAG and STA-9090 reduced the activity of the MAPK and PI3K/AKT signaling pathways, whereas AUY922 led to a compensatory upregulation of downstream ERK. Furthermore, all three tested HSP90 inhibitors displayed a synergistic combination effect with trabectidin, but not with doxorubicin. In conclusion, our results indicate that different HSP90 inhibitors, albeit having the same target, can vary significantly in downstream effects and treatment outcomes. These results should be considered before proceeding into clinical trials against MLS or other malignancies.

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Complete pathological response to neoadjuvant treatment is associated with better survival outcomes in patients with soft tissue sarcoma: Results of a retrospective multicenter study

Cited by 41 publications

References 28 publications

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Clinical Outcomes for Primary and Radiation-Associated Angiosarcoma of the Breast with Multimodal Treatment: Long-Term Survival Is Achievable

Is 5 the New 25? Long-Term Oncologic Outcomes From a Phase II, Prospective, 5-Fraction Preoperative Radiation Therapy Trial in Patients With Localized Soft Tissue Sarcoma

Different HSP90 Inhibitors Exert Divergent Effect on Myxoid Liposarcoma In Vitro and In Vivo

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