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López-Álvarez M, González-Aguilera C, Moura DS, Sánchez-Bustos P, Mondaza-Hernández JL, Martín-Ruiz M, Renshaw M, Ramos R, Castilla C, Blanco-Alcaina E, Hindi N, Martín-Broto J. Efficacy of Eribulin Plus Gemcitabine Combination in L-Sarcomas. Int J Mol Sci 2022; 24:ijms24010680. [PMID: 36614121 PMCID: PMC9820645 DOI: 10.3390/ijms24010680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
Although the overall survival of advanced soft-tissue sarcoma (STS) patients has increased in recent years, the median progression-free survival is lower than 5 months, meaning that there is an unmet need in this population. Among second-line treatments for advanced STS, eribulin is an anti-microtubule agent that has been approved for liposarcoma. Here, we tested the combination of eribulin with gemcitabine in preclinical models of L-sarcoma. The effect in cell viability was measured by MTS and clonogenic assay. Cell cycle profiling was studied by flow cytometry, while apoptosis was measured by flow cytometry and Western blotting. The activity of eribulin plus gemcitabine was evaluated in in vivo patient-derived xenograft (PDX) models. In L-sarcoma cell lines, eribulin plus gemcitabine showed to be synergistic, increasing the number of hypodiploid events (increased subG1 population) and the accumulation of DNA damage. In in vivo PDX models of L-sarcomas, eribulin combined with gemcitabine was a viable scheme, delaying tumour growth after one cycle of treatment, being more effective in leiomyosarcoma. The combination of eribulin and gemcitabine was synergistic in L-sarcoma cultures and it showed to be active in in vivo studies. This combination deserves further exploration in the clinical context.
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Affiliation(s)
- María López-Álvarez
- Institute of Biomedicine of Sevilla, IBIS, Hospital Universitario Virgen del Rocío-HUVR, Consejo Superior de Investigaciones Científicas-CSIC, Universidad de Sevilla, 41013 Sevilla, Spain
| | - Cristina González-Aguilera
- Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER), Universidad de Sevilla-CSIC, Universidad Pablo de Olavide, 41092 Sevilla, Spain
- Departamento de Biología Celular, Facultad de Biología, Universidad de Sevilla, 41013 Sevilla, Spain
| | - David S. Moura
- Instituto de Investigación Sanitaria Fundación Jiménez Diaz (IIS/FJD), 28015 Madrid, Spain
| | - Paloma Sánchez-Bustos
- Institute of Biomedicine of Sevilla, IBIS, Hospital Universitario Virgen del Rocío-HUVR, Consejo Superior de Investigaciones Científicas-CSIC, Universidad de Sevilla, 41013 Sevilla, Spain
| | | | - Marta Martín-Ruiz
- Instituto de Investigación Sanitaria Fundación Jiménez Diaz (IIS/FJD), 28015 Madrid, Spain
| | - Marta Renshaw
- Instituto de Investigación Sanitaria Fundación Jiménez Diaz (IIS/FJD), 28015 Madrid, Spain
| | - Rafael Ramos
- Pathology Department, University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Carolina Castilla
- Nodo Biobanco Hospital Universitario Virgen del Rocío-Instituto de Biomedicina de Sevilla, Biobanco del SSPA, Unidad de Anatomía Patológica, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
| | - Elena Blanco-Alcaina
- Institute of Biomedicine of Sevilla, IBIS, Hospital Universitario Virgen del Rocío-HUVR, Consejo Superior de Investigaciones Científicas-CSIC, Universidad de Sevilla, 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Nadia Hindi
- Instituto de Investigación Sanitaria Fundación Jiménez Diaz (IIS/FJD), 28015 Madrid, Spain
- Medical Oncology Department, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Collado Villalba, 28400 Madrid, Spain
| | - Javier Martín-Broto
- Instituto de Investigación Sanitaria Fundación Jiménez Diaz (IIS/FJD), 28015 Madrid, Spain
- Medical Oncology Department, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Collado Villalba, 28400 Madrid, Spain
- Correspondence: ; Tel.: +34-955923113
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Hindi N, Carrasco García I, Sánchez-Camacho A, Gutierrez A, Peinado J, Rincón I, Benedetti J, Sancho P, Santos P, Sánchez-Bustos P, Marcilla D, Encinas V, Chacon S, Muñoz-Casares C, Moura D, Martin-Broto J. Trabectedin Plus Radiotherapy for Advanced Soft-Tissue Sarcoma: Experience in Forty Patients Treated at a Sarcoma Reference Center. Cancers (Basel) 2020; 12:cancers12123740. [PMID: 33322663 PMCID: PMC7764328 DOI: 10.3390/cancers12123740] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 01/30/2023] Open
Abstract
Simple Summary Active therapeutic options in advanced sarcomas, able to induce durable objective responses, are scarce beyond first line. New strategies for disease and symptomatic control are thus needed. Our aim was to analyze the activity of the combination of trabectedin and palliative radiotherapy in the real-life setting, in patients with pretreated metastatic sarcoma. Our findings on 40 pretreated metastatic soft-tissue sarcoma patients, in terms of objective responses (overall response rate by RECIST of 32.5%) and outcome (median progression-free survival of 7.5 months and median overall survival of 23.5 months), confirm the activity of this regimen, which is a valuable option to consider, especially in patients in which a dimensional response could help for symptomatic control. Abstract Symptomatic control and tumoral shrinkage is an unmet need in advanced soft-tissue sarcoma (STS) patients beyond first-line. The combination of trabectedin and radiotherapy showed activity in a recently reported clinical trial in this setting. This retrospective series aims to analyze our experience with the same regimen in the real-life setting. We retrospectively reviewed advanced sarcoma patients treated with trabectedin concomitantly with radiotherapy with palliative intent. Growth-modulation index (GMI) was calculated as a surrogate of efficacy. Forty metastatic patients were analyzed. According to RECIST, there was one (2.5%) complete response, 12 (30%) partial responses, 18 (45%) disease stabilizations, and nine (22.5%) progressions. After a median follow-up of 15 months (range 2–38), median progression-free survival (PFS) and overall survival (OS) were 7.5 months (95% CI 2.8–12.2) and 23.5 months (95% CI 1.1–45.8), respectively. Median GMI was 1.42 (range 0.19–23.76), and in 16 (53%) patients, it was >1.33. In patients with GMI >1.33, median OS was significantly longer than in those with GMI 0–1.33 (median OS 52.1 months (95% CI not reached) vs. 8.9 months (95% CI 6.3–11.6), p = 0.028). The combination of trabectedin plus radiotherapy is an active therapeutic option in patients with advanced STS, especially when tumor shrinkage for symptomatic relief is needed.
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Affiliation(s)
- Nadia Hindi
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
| | - Irene Carrasco García
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
| | - Alberto Sánchez-Camacho
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
| | - Antonio Gutierrez
- Hematology Department, University Hospital Son Espases, 07120 Mallorca, Spain;
| | - Javier Peinado
- Radiation Oncology Department, University Hospital Virgen del Rocio, 41013 Sevilla, Spain; (J.P.); (I.R.)
- Biología Molecular del Cáncer, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Inmaculada Rincón
- Radiation Oncology Department, University Hospital Virgen del Rocio, 41013 Sevilla, Spain; (J.P.); (I.R.)
| | - Johanna Benedetti
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
| | - Pilar Sancho
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
| | - Paloma Santos
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
| | - Paloma Sánchez-Bustos
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
| | - David Marcilla
- Pathology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain;
| | - Victor Encinas
- Musculoskeletal Unit, Radiology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain;
| | - Sara Chacon
- Musculoskeletal Tumor Unit, Orthopedics Surgery Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain;
| | - Cristobal Muñoz-Casares
- Surgery Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain;
| | - David Moura
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
| | - Javier Martin-Broto
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain; (N.H.); (I.C.G.); (A.S.-C.); (J.B.); (P.S.); (P.S.)
- TERABIS Group, IBiS (Instituto de Biomedicina de Sevilla), 41013 Sevilla, Spain; (P.S.-B.); (D.M.)
- Correspondence: ; Tel.: +34-629-108-979
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