Long Lasting Response of Trabectedin in Patient With Gastric Leiomyosarcoma With Liver Metastasis: an Update to Previous Report

Rastogi, Sameer; Kalra, Kaushal; Manasa, Parisa; Rajawat, Monali; Team, Editorial

doi:10.2144/fsoa-2019-0085

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…The data on trabectedin is sparse from developing countries with occasional case reports. 26 There is a need of collaborative studies from the developing world.…”

Section: Discussionmentioning

confidence: 99%

Trabectedin in Advanced Sarcomas—Experience at a Tertiary Care Center and Review of Literature

Verma

Kalra

Rastogi

et al. 2021

South Asian J Cancer

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Background There is sparse literature on trabectedin in advanced soft-tissue sarcomas from developing world. It would be interesting to know about use and outcomes of trabectedin in Indian patients. Method In a retrospective study, consecutive patients treated with trabectedin from 2016 to 2019 were analyzed. Patients with L-sarcomas were treated at a dose of 1.5 mg/m2, while those with translocation-related sarcomas were treated at a dose of 1.2 mg/m2 as a 24-hour infusion through peripherally inserted central catheter line. From July 2019, infusions were administered through an ambulatory elastomeric pump, while before that patients were admitted for 24 hours. We used SPSS version 23.0 for statistical calculation. Result A total of 20 patients received trabectedin with a total of 116 infusions. The median age was 46 years (range: 22–73 years). The male (n = 11, 55%) and female patients were almost equal (n = 9, 45%). Thirteen patients (65%) had Eastern Cooperative Oncology Group Performance Status 1. Majority of the patients had leiomyosarcoma (n = 8, 40%); remaining comprised of liposarcoma (3, 15%), translocation-related sarcomas excluding myxoid liposarcoma (n = 8, 40%) and others (n = 1,5%). Most common site was extremity (n = 11, 55%) followed by retroperitoneal (n = 3, 15%), visceral (n = 3, 15%), and others (n = 3,15%). Median number of previous lines received was 2 (range: 0–4). Median number of trabectedin cycles received was 4 (range: 1–17). Best response assessed was stable disease (n = 10, 50%), progressive disease (n = 6, 30%), partial response (n = 1, 5%), and not assessed in 3 patients. After a median follow-up of 19 months, median progression-free survival was 4 months. Conclusion In this heavily treated population (composed of L-sarcomas and translocation-related sarcomas) with many patients with poor performance status, the outcome with trabectedin is in synchrony with literature. However, the need of 24-hour admission might deter quality of life. Elastomeric pump seems to be a reasonable alternative to admission and can be a breakthrough in administering trabectedin, especially in developing countries.

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“…The data on trabectedin is sparse from developing countries with occasional case reports. 26 There is a need of collaborative studies from the developing world.…”

Section: Discussionmentioning

confidence: 99%

Trabectedin in Advanced Sarcomas—Experience at a Tertiary Care Center and Review of Literature

Verma

Kalra

Rastogi

et al. 2021

South Asian J Cancer

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“…On occasion excision, radiation or ablation of under-responding metastases can allow this. A number of investigators have now reported long treatment times with disease stability utilizing trabectedin [ 1 - 3 ]. This case report represents a patient with a prolonged treatment time on trabectedin.…”

Section: Introductionmentioning

confidence: 99%

A Prolonged Response and Characteristics of Trabectedin Treatment of Metastatic Soft Tissue Sarcoma

Reuben

2021

J Med Cases

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Unique features and treatment effects of trabectedin are presented in consideration of soft tissue sarcoma management. A prolonged time on trabectedin through 59 cycles is shown. This is one of the longer reported uses of trabectedin successfully to control disease. Adjunctive cytoreduction options with surgery, radiation or ablation are presented. Future studies would be helpful to investigate treatment holidays, the impact of multi-modality care and assessment of genetics of clonal metastases. This may assist in guiding and selecting patients for priority treatment with trabectedin.

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“…Leiomyosarcoma (LMS) represents about 1% of primary malignancies of the stomach, evolves with hepatic implants in 2-thirds of cases, and the outcome is often poor [1][2][3][4][5][6][7]. Immunosuppression, Epstein-Barr virus, chemicals, and radiation can be related factors [2,6].…”

Section: Introductionmentioning

confidence: 99%

“…Spindle cells of the muscularis propria or muscularis mucosa present high proliferation rates and positivity for desmin, a-muscle-specific actin, and vimentin [2,3,6]. Although immunohistochemical findings can avoid pitfalls with other gastrointestinal tumors, the diagnosis often occurs at late stages because of the insidious clinical course [2][3][4][5][6][7]. LMS predominantly affects female adults (5:3) and the sixth decade of life, pain occurs in near 75% of patients and the control is very difficult in most of them [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Recurrences after resections and distant metastases may develop in up to 50% of patients [5]. Anthracycline-based chemotherapy, ifosfamide, gemcitabine, docetaxel, trabectedin, and pazopanib constitute additional therapeutic options, with variable response rates [6,7]. Because of the exceeding rarity, case reports can increase the understanding of gastric LMS.…”

Section: Introductionmentioning

confidence: 99%

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Metastatic leiomyosarcoma of the excluded stomach: a case report

Silva

Santos

Santos³

2020

Journal of Gastric Surgery

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Background: Leiomyosarcoma (LMS) represents about 1% of primary malignancies of the stomach, usually evolves with hepatic implants in 2-thirds of cases, and the outcome is frequently poor. With an insidious course, late diagnosis and misdiagnosis with other gastric neoplasia occur. Immunohistochemical evaluations are mandatory to confirm the diagnostic hypothesis. Surgical resection has been the more effective treatment of gastric LMS; however, recurrences after resections and distant metastases may develop in up to 50% of the patients. Doxorubicin, gemcitabine, and docetaxel are therapeutic options, with variable responses. Case presentation: The 52-year-old male herein described with a diagnosis of LMS in the gastric pouch and liver metastasis underwent a Roux-en-Y bypass to treat morbid obesity more than a decade ago. Persistent abdominal pain was a unique symptom, and he had liver metastasis at diagnosis. The initial hypothesis was a metastatic gastrointestinal stromal tumor (GIST) of the excluded stomach and the patient underwent a schedule with imatinib without significant response. After a complete revision of the anatomopathological findings, the patient underwent a new biopsy of the gastric mass, and the immunohistochemical data were consistent with LMS. Then doxorubicin replaced imatinib, later changed by gemcitabine associated with docetaxel. As last control found lesions in the central nervous system, he is under radiotherapy sessions. Conclusion: The diagnosis of gastric LMS often occurs at late stages because of the insidious clinical course. The rate of liver metastasis at diagnosis is high. Besides, the relatively poor response to the alternative management for non-surgical stages of the disease yields severe outcomes.

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Long Lasting Response of Trabectedin in Patient With Gastric Leiomyosarcoma With Liver Metastasis: an Update to Previous Report

Cited by 5 publications

References 23 publications

Trabectedin in Advanced Sarcomas—Experience at a Tertiary Care Center and Review of Literature

Trabectedin in Advanced Sarcomas—Experience at a Tertiary Care Center and Review of Literature

A Prolonged Response and Characteristics of Trabectedin Treatment of Metastatic Soft Tissue Sarcoma

Metastatic leiomyosarcoma of the excluded stomach: a case report

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