1
|
Li T, Dong Y, Wei Y, Wang S, Liu Y, Chen J, Xiong W, Lin N, Huang X, Liu M, Yan X, Ye Z, Li B. First-Line Anlotinib Treatment for Soft-Tissue Sarcoma in Chemotherapy-Ineligible Patients: An Open-Label, Single-Arm, Phase 2 Clinical Trial. Clin Cancer Res 2024; 30:4310-4317. [PMID: 38483309 PMCID: PMC11443219 DOI: 10.1158/1078-0432.ccr-23-3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/21/2024] [Accepted: 03/12/2024] [Indexed: 10/02/2024]
Abstract
PURPOSE Standard treatment for patients with unresectable locally advanced or metastatic soft-tissue sarcoma (LA/M STS) is chemotherapy based on anthracyclines, but patient tolerance of chemotherapy is limited. The present trial (NCT03792542) investigated the use of anlotinib as first-line treatment for patients with advanced STS, in particular liposarcoma. PATIENTS AND METHODS Eligible patients were previously untreated, pathologically confirmed, unresectable LA/M STS cases. Anlotinib was given orally at a dose of 12 mg once daily from days 1 to 14 every 3 weeks until disease progression or intolerable adverse events (AE) occurred. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate, and disease control rate (DCR). The safety profile was also evaluated. RESULTS Forty patients were enrolled from April 2019 to June 2022 and are included in the intention-to-treat analysis. The median PFS was 6.83 months [95% confidence interval (CI), 4.17-8.71] and the median OS 27.40 months (95% CI, 16.43-not evaluable); 1 patient reached partial response and 26 attained stable disease, with a DCR of 67.5% (27/40). Median PFS and OS times for liposarcoma patients were 8.71 and 16.23 months, respectively. Ten (25.0%) patients had treatment-related AEs ≥ grade 3, with in particular a higher incidence of hypertension (15.0%) and proteinuria (7.5%). CONCLUSIONS The findings suggest a potential benefit in using front-line anlotinib to treat patients with STS, who are not eligible for cytotoxic chemotherapy. Of note, the clinical outcomes for the liposarcoma subgroup of patients were encouraging. See related commentary by Napolitano et al., p. 4257.
Collapse
Affiliation(s)
- Tao Li
- Department of Bone and Soft-tissue Surgery, Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
| | - Ying Dong
- Medical Oncology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Yongzhong Wei
- Department of Orthopaedics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Shoufeng Wang
- Division of Musculoskeletal Tumor, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | - Yunxia Liu
- Department of Oncology, Hangzhou Third People’s Hospital, Hangzhou, China.
| | - Jia Chen
- Department of Oncology, Jiangsu Cancer Hospital, Nanjing, China.
| | - Wenhua Xiong
- Department of Orthopaedics, Ningbo Second Hospital, Ningbo, China.
| | - Nong Lin
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xin Huang
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Meng Liu
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xiaobo Yan
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhaoming Ye
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Binghao Li
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| |
Collapse
|
2
|
Chen H, Liu Y, Peng F, Huang J, Wen X, Ding Z, Zhang S, Zhang Y, Lu Y. Pulmonary metastases of fibrosarcomatous dermatofibrosarcoma protuberans respond to apatinib-based angiogenesis and chemotherapy: a case report. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:149. [PMID: 31157270 DOI: 10.21037/atm.2019.02.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Dermatofibrosarcoma protuberans (DFSP) is soft tissue malignancy which is locally aggressive, slow-growth, rarely metastasizing but recurs frequently after surgical excision. Fibrosarcomatous dermatofibrosarcoma protuberans (FS-DFSP) is a variant of DFSP with a higher risk of recurrence and metastasis. For treatment of metastatic DFSP, antiangiogenesis therapy is an important therapeutic option, which is beneficial in increasing the efficacy of chemotherapy. Apatinib is a novel vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor and revealed potential anti-tumor efficacy in some types of sarcomas. However, there is still no report of apatinib as an angiogenesis therapy for metastatic DFSP to date. Herein we first describe a case of FS-DFSP relapsed and metastasized post multiple surgeries and adjuvant radiotherapy responded to apatinib in combination with chemotherapy, indicating apatinib may be a potential therapeutic option for metastatic DFSP.
Collapse
Affiliation(s)
- Huimin Chen
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yongmei Liu
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Peng
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Juan Huang
- Department of Hematology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine UESTC, Chengdu 610072, China
| | - Xiang Wen
- Department of Dermatology, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhenyu Ding
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shouyue Zhang
- Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yan Zhang
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - You Lu
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
3
|
Martin-Liberal J, Pérez E, García Del Muro X. Investigational therapies in phase II clinical trials for the treatment of soft tissue sarcoma. Expert Opin Investig Drugs 2018; 28:39-50. [DOI: 10.1080/13543784.2019.1555236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Juan Martin-Liberal
- Sarcoma, Melanoma and Genitourinary Tumors Unit, Institut Català d’Oncologia (ICO) L’Hospitalet, Barcelona, Spain
- Molecular Therapeutics Research Unit (UITM), Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), CIBERONC, Barcelona, Spain
| | - Ezequiel Pérez
- Department of Medical Oncology, Institute of Oncology Ángel H Roffo, Buenos Aires, Argentina
| | - Xavier García Del Muro
- Sarcoma, Melanoma and Genitourinary Tumors Unit, Institut Català d’Oncologia (ICO) L’Hospitalet, Barcelona, Spain
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), CIBERONC, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
4
|
Lou S, Balluff B, de Graaff MA, Cleven AHG, Briaire-de Bruijn I, Bovée JVMG, McDonnell LA. High-grade sarcoma diagnosis and prognosis: Biomarker discovery by mass spectrometry imaging. Proteomics 2017; 16:1802-13. [PMID: 27174013 DOI: 10.1002/pmic.201500514] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 12/24/2022]
Abstract
The combination of high heterogeneity, both intratumoral and intertumoral, with their rarity has made diagnosis, prognosis of high-grade sarcomas difficult. There is an urgent need for more objective molecular biomarkers, to differentiate between the many different subtypes, and to also provide new treatment targets. Mass spectrometry imaging (MSI) has amply demonstrated its ability to identify potential new markers for patient diagnosis, survival, metastasis and response to therapy in cancer research. In this study, we investigated the ability of MALDI-MSI of proteins to distinguish between high-grade osteosarcoma (OS), leiomyosarcoma (LMS), myxofibrosarcoma (MFS) and undifferentiated pleomorphic sarcoma (UPS) (Ntotal = 53). We also investigated if there are individual proteins or protein signatures that are statistically associated with patient survival. Twenty diagnostic protein signals were found characteristic for specific tumors (p ≤ 0.05), amongst them acyl-CoA-binding protein (m/z 11 162), macrophage migration inhibitory factor (m/z 12 350), thioredoxin (m/z 11 608) and galectin-1 (m/z 14 633) were assigned. Another nine protein signals were found to be associated with overall survival (p ≤ 0.05), including proteasome activator complex subunit 1 (m/z 9753), indicative for non-OS patients with poor survival; and two histone H4 variants (m/z 11 314 and 11 355), indicative of poor survival for LMS patients.
Collapse
Affiliation(s)
- Sha Lou
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Benjamin Balluff
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands.,Maastricht MultiModal Molecular Imaging Institute, Maastricht University, Maastricht, The Netherlands
| | - Marieke A de Graaff
- Department of Pathology, Leiden University, Medical Center, Leiden, The Netherlands
| | - Arjen H G Cleven
- Department of Pathology, Leiden University, Medical Center, Leiden, The Netherlands
| | | | - Judith V M G Bovée
- Department of Pathology, Leiden University, Medical Center, Leiden, The Netherlands
| | - Liam A McDonnell
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands.,Department of Pathology, Leiden University, Medical Center, Leiden, The Netherlands.,Fondazione Pisana per la Scienza ONLUS, Pisa, Italy
| |
Collapse
|
5
|
Bulut G, Ozluk A, Erdogan AP, Uslu R, Elmas N, Karaca B. Pazopanib: a novel treatment option for aggressive fibromatosis. Clin Sarcoma Res 2016; 6:22. [PMID: 27957320 PMCID: PMC5131445 DOI: 10.1186/s13569-016-0061-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aggressive fibromatosis (AF), also known as desmoid tumor, is an uncommon soft tissue neoplasm. AF does not metastasize, but it is locally invasive and its propensity for recurrence after conservative resection is well documented. No effective cytotoxic treatment has been reported, hence there is a need for novel treatment strategies. CASE PRESENTATION We present the case of an AF successfully treated with an oral tyrosine kinase inhibitor, pazopanib, with mild side effects. As far as we know, this is the first case of AF with complete response to pazopanib. CONCLUSION Pazopanib might be an effective treatment option for AF.
Collapse
Affiliation(s)
- Gulcan Bulut
- Department of Medical Oncology, Ege University Medical School, Tulay Aktas Oncology Hospital, Ege University, Izmir, Turkey
| | - Anil Ozluk
- Department of Internal Medicine, Ege University Medical School, Ege University Medical School Hospital, Ege University, Izmir, Turkey
| | - Atike Pınar Erdogan
- Department of Medical Oncology, Ege University Medical School, Tulay Aktas Oncology Hospital, Ege University, Izmir, Turkey
| | - Ruchan Uslu
- Department of Medical Oncology, Ege University Medical School, Tulay Aktas Oncology Hospital, Ege University, Izmir, Turkey
| | - Nevra Elmas
- Department of Radiology, Ege University Medical School, Ege University Medical School Hospital, Ege University, Izmir, Turkey
| | - Burcak Karaca
- Department of Medical Oncology, Ege University Medical School, Tulay Aktas Oncology Hospital, Ege University, Izmir, Turkey
| |
Collapse
|
6
|
Versleijen-Jonkers YMH, Vlenterie M, van de Luijtgaarden ACM, van der Graaf WTA. Anti-angiogenic therapy, a new player in the field of sarcoma treatment. Crit Rev Oncol Hematol 2014; 91:172-85. [PMID: 24613529 DOI: 10.1016/j.critrevonc.2014.02.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/19/2013] [Accepted: 02/05/2014] [Indexed: 01/12/2023] Open
Abstract
Sarcomas encompass a heterogeneous family of mesenchymal malignancies. In metastatic disease improvement in outcome has been limited and there is a clear need for the development of new therapies. One potential target is angiogenesis, already an accepted target for treatment of more prevalent cancers. Multiple (pre)clinical studies focused on the role of angiogenesis and anti-angiogenic treatment in sarcomas. However, getting significant results is complicated due to the relatively small number of patients and the broad range of sarcoma subtypes. Recently, pazopanib has been approved for the treatment of advanced soft tissue sarcoma patients, which is an important step forward and paves the way for the introduction of anti-angiogenic treatment in sarcomas. However, more studies are needed to understand the biological mechanisms by which patients respond to angiogenic inhibitors and to detect markers of response. This review covers the knowledge that has been gained on the role of angiogenesis and anti-angiogenic therapy in sarcomas.
Collapse
Affiliation(s)
- Yvonne M H Versleijen-Jonkers
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Myrella Vlenterie
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Internal Postal Code 452, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| |
Collapse
|
7
|
Martin-Liberal J, Benson C, McCarty H, Thway K, Messiou C, Judson I. Pazopanib is an active treatment in desmoid tumour/aggressive fibromatosis. Clin Sarcoma Res 2013; 3:13. [PMID: 24279994 PMCID: PMC4176486 DOI: 10.1186/2045-3329-3-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 11/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background Desmoid tumours/aggressive fibromatosis (DT/AF) are infrequent soft-tissue neoplasms. They usually behave as indolent diseases. However, they may grow locally infiltrating or compressing adjacent structures. The role of local treatment is limited and only a few drugs have shown activity. Cases presentation We report the outcome of two patients affected by progressive DT/AF treated with the angiogenesis inhibitor pazopanib in two different institutions. Both patients achieved dramatic improvement in their symptoms and radiological signs of response. The clinical benefit lasted for more than 1 year and it is still ongoing. Conclusions Pazopanib is an active treatment in DT/AF. It is the first time this has been reported.
Collapse
|