Phase II clinical trial of neoadjuvant trabectedin in patients with advanced localized myxoid liposarcoma

Gronchi, Alessandro; Bui, Binh; Bonvalot, Sylvie; Pilotti, Silvana; Ferrari, Stefano; Hohenberger, Peter; Hohl, Raymond J.; Demetri, George D.; Cesne, Axel Le; Lardelli, Pilar; Pérez, I. Brao; Nieto, Antonio; Tercero, Juan Carlos; Alfaro, Vicente; Tamborini, Elena; Blay, Jean‐Yves

doi:10.1093/annonc/mdr265

Cited by 132 publications

(93 citation statements)

References 22 publications

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“…22,23 It is noteworthy that pathologic responses without any decrease in size were reported even in patients with solid tumors who received cytotoxic chemotherapy. Patients with myxoid liposarcoma who received trabectedin 24,25 and patients with osteosarcoma who received chemotherapy [26][27][28] are examples among sarcomas. We previously demonstrated that Choi criteria adapted to magnetic resonance imaging (MRI) correlated better with pathologic tumor response than RECIST in a series of 38 patients with high-grade soft tissue sarcomas who received preoperative chemotherapy with or without radiation therapy within a prospective phase 3 Italian Sarcoma Group/Spanish Sarcoma Group trial.…”

Section: Introductionmentioning

confidence: 99%

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

Stacchiotti

Verderio²,

Messina

et al. 2012

Cancer

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BACKGROUND. The objective of this study was to compare the prognostic relevance of Response Evaluation Criteria in Solid Tumors (RECIST) versus Choi criteria for the assessment of response in patients with high-risk soft tissue sarcoma of the extremities or trunk wall who received preoperative chemotherapy with or without radiotherapy in a phase 3 trial. METHODS. Patients received 3 cycles of preoperative epirubicin þ ifosfamide with or without radiotherapy. The diagnostic concordance between RECIST and Choi criteria and their correlation with overall survival (OS) and freedom from progression (FFP) were evaluated in a univariate Cox regression model. RESULTS. In 243 of 321 eligible patients, RECIST, Choi criteria, and histology were predictive for OS and FFP. In the subgroup of 69 patients who received chemotherapy alone and were evaluable by both RECIST and Choi criteria, Choi criteria were associated significantly with OS and FFP, whereas RECIST predicted only FFP, and the pattern of agreement observed between the 2 criteria was unsatisfactory. On a dichotomous scale, comparing objective response (complete and partial responses) and lack of response (stable and progressive disease) to preoperative chemotherapy according to RECIST and Choi criteria, only Choi criteria were predictive of OS and FFP, and fair agreement between RECIST and Choi criteria was observed. When lack of progression and progression were compared (complete and partial responses þ stable disease vs progressive disease), both assessment criteria were significantly predictive of OS and FFP, and there was substantial agreement between the 2 criteria. CONCLUSIONS. Response to chemotherapy with or without radiotherapy was associated with a better outcome in patients with high-risk soft tissue sarcoma. Choi criteria were better predictors than RECIST in patients who received preoperative chemotherapy alone. Cancer 2012;118:5857-66.

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Section: Introductionmentioning

confidence: 99%

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

Stacchiotti

Verderio²,

Messina

et al. 2012

Cancer

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“…The low-grade variant can be treated by preoperative RT. 33 The high-grade variant, which is marked by the presence of spindle cell or round cell morphology, may be treated by both anthracycline-based CT regimens 34 35,36 Response to these treatments will allow potentially more conservative operations with very limited local risk.…”

Section: Personalizing Surgery To Response To Neoadjuvant Therapymentioning

confidence: 99%

Surgical management of localized soft tissue tumors

Gronchi

Colombo

Raut

2014

Cancer

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Soft tissue tumors are rare and can arise from a variety of soft tissues and viscera in a variety of body sites. Their management requires a thorough understanding of the biology of the different histologies and molecular subtypes as well as the constraints of specific anatomic sites. The surgical approach has undergone significant changes thanks to a better understanding of the natural history of the different histologic subtypes, the importance of site, and the different sensitivity to available drugs. The soft tissue tumor family includes 3 major, distinct categories: desmoid-type fibromatosis, soft tissue sarcoma, and gastrointestinal stromal tumor. In general, limb-sparing and function-sparing approaches should be used when feasible for tumors located in the extremities and girdles. Resections of adherent structures/viscera, which may be close but not invaded, may be needed in tumors arising in the retroperitoneum/abdomen to minimize microscopic intralesional margins, maximize local tumor control, and possibly improve survival. Margins of resection and the use of adjuvant/neadjuvant radiation therapy and/or chemotherapy are contingent on an accurate histologic diagnosis. Treatment planning should include multidisciplinary consultation to determine optimal therapy, taking into consideration tumor histology, site and extent of the disease, its natural history and sensitivity to available treatments, surgical challenges, and-of course-quality of life. Cancer 2014;120:2638-48.

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“…Assessment of antitumor activity of preoperative chemotherapy in different histological subtypes, therefore, might be the challenge in future. In a small phase II trial 23 patients with locally advanced myxoid liposarcomas were treated with neoadjuvant trabectedin [15]. Overall, 3 out of 23 patients showed a pathological complete remission per central pathological review very good and good tumor regressions were found in 12/23 patients.…”

Section: Dose Intensity and Type Of Chemotherapymentioning

confidence: 99%

Neoadjuvant chemotherapy for soft tissue sarcoma

Wöll¹

2014

memo

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Soft tissue sarcoma is a rare and very heterogeneous disease. The prognosis of these cancers is mainly influenced by histological grading size location and type of histology. Many aspects argue in favor of neoadjuvant chemotherapy but no singular trial could unambiguously prove an advantage of neoadjuvant therapy. This short review has a focus on neoadjuvant chemotherapy as induction therapy prior to chemoradiation or neoadjuvant chemotherapy alone.

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Phase II clinical trial of neoadjuvant trabectedin in patients with advanced localized myxoid liposarcoma

Cited by 132 publications

References 22 publications

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

Surgical management of localized soft tissue tumors

Neoadjuvant chemotherapy for soft tissue sarcoma

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