First-line anthracycline-based chemotherapy for angiosarcoma and other soft tissue sarcoma subtypes: Pooled analysis of eleven European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group trials |
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| Institution: | 1. Memorial Sloan Kettering Cancer Center, New York, NY, USA;2. The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA;3. Fox Chase Cancer Center, Philadelphia, PA, USA;4. Stanford Hospital and Clinics, Stanford, CA, USA;5. Seattle Cancer Care Alliance/University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA;6. Arthur James Cancer Center, Columbus, OH, USA;7. Indiana University, Simon Cancer Center, Indianapolis, IN, USA;8. University of Iowa Hospitals and Clinics, Iowa City, IA, USA;9. St. Joseph''s Hospital & Medical Center, Phoenix, AZ, USA;10. Janssen Research & Development LLC, Raritan, NJ, USA;11. Mount Sinai School of Medicine, New York, NY, USA;12. Dana-Farber Cancer Institute, Harvard Medical School, and Ludwig Center at Harvard, Boston, MA, USA;1. Department of Medical Oncology, Institut Bergonié, Bordeaux;2. Department of Surgical Oncology, Institut Gustave Roussy, Villejuif;3. Department of Surgical Oncology, Centre Léon Bérard, Lyon;4. Department of Surgical Oncology, Institut Bergonié, Bordeaux;5. Department of Radiation Oncology, Institut Régional du Cancer Montpellier, Montpellier;6. Department of Medical Oncology, Centre Georges François Leclerc, Dijon;7. Department of Medical Oncology, Centre René Gauducheau, Nantes;8. Department of Medical Oncology, Centre Oscar Lambret, Lille;9. Department of Medical Oncology, Centre François Baclesse, Caen;10. Department of Medical Oncology, Centre Antoine Lacassagne, Nice;11. Departments of Medical Oncology;12. Radiation Oncology, Institut Gustave Roussy, Villejuif;13. Department of Medical Oncology, Centre Léon Bérard, Lyon;14. Department of Medical Oncology, Institut Curie, Paris;15. Department of Medical Oncology, Centre Claudius Regaud, Toulouse;16. Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand;17. Department of Clinical and Epidemiological Research, Institut Bergonié, Bordeaux;18. Department of Pathology, Institut Gustave Roussy, Villejuif;19. Department of Pathology, Centre Léon Bérard, Lyon;20. Department of Pathology, Institut Bergonié, Bordeaux, France;1. Department of Medical Oncology, Institut Bergonié, Bordeaux;2. Department of Medical Oncology, Hôpital Cochin, Paris, France;3. Sarcoma Service, Memorial Sloan Kettering Cancer Center, New York, USA;4. Department of Medicine, Istituto Rizzoli, Bologna, Italy;5. Department of Medical Oncology, Institut Curie, Paris;6. Department of Medical Oncology, Centre Eugène Marquis, Rennes;7. Department of Medical Oncology, University Hospital Centre of Besançon, Besançon;8. Department of Medicine, Centre Oscar Lambret, Lille;9. Department of Medical Oncology, Hôpital La Timone, Marseille;10. Department of Medical Oncology, University Hospital Centre of Strasbourg, Strasbourg;11. Department of Medical Oncology, Institut de Cancérologie de la Loire, Saint Priest en Jarez;12. Department of Medical Oncology, Institut Paoli Calmettes, Marseille;13. Department of Medical Oncology, Centre René Gauducheau, Nantes;14. Department of Medicine, Institut Gustave Roussy, Villejuif;15. Department of Medicine, Centre Léon Bérard, Lyon, France |
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| Abstract: | BackgroundAngiosarcoma is a rare subtype of soft tissue sarcoma (STS). Doxorubicin is the standard first-line chemotherapy for advanced STS. It is not known whether angiosarcoma response to anthracycline-based chemotherapy is different to other STS subtypes.MethodsPooled data were analysed from 11 prospective randomised and non-randomised European Organisation for Research and Treatment of Cancer (EORTC) clinical trials of first-line anthracycline-based chemotherapy for advanced STS. Baseline patient characteristics, chemotherapy response, progression free survival (PFS) and overall survival (OS) of angiosarcoma patients were compared with other STS patients. Analysis was performed to identify factors prognostic for angiosarcoma response to chemotherapy, PFS and OS.ResultsWith a median follow-up of 4.2 years, data from 108 locally advanced and metastatic angiosarcoma patients and 2557 patients with other STS histologies were analysed. 25% of angiosarcoma patients had a complete or partial response to chemotherapy compared to 21% for other STS histotypes. The median PFS was 4.9 months and OS 9.9 months, which were not significantly different from other STS histotypes. In univariate analysis, bone metastases were an adverse prognostic factor for OS (hazard ratio (HR) 1.66, 95% confidence interval (CI) 1.03–2.67; p = 0.036). Tumour grade was as an adverse prognostic factor for PFS (HR 1.72, 95% CI 1.01–2.92; p = 0.044) and OS (HR 2.03; 95% CI 1.16–3.56; p = 0.011). Compared to single agent anthracyclines, doxorubicin + ifosfamide was associated with improved PFS (HR 0.53, 95% CI 0.33–0.86; p = 0.010) and OS (HR 0.53, 95% CI 0.32–0.90; p = 0.018).ConclusionsAngiosarcoma response and survival following first-line anthracycline-based chemotherapy was similar to other STS histotypes. Our analysis provides a useful measure of angiosarcoma response to chemotherapy for comparison with future clinical trials. |
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| Keywords: | Angiosarcoma Soft tissue sarcoma Chemotherapy Doxorubicin |
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