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Palliative Chemotherapy in Epithelioid Sarcoma

Palliative Chemotherapy in Epithelioid Sarcoma. Robin L Jones, Anastasia Constantinidou, Khin Thway, Cyril Fisher, Omar Al-Muderis, Michelle Scurr, Ian R Judson Sarcoma Unit, Royal Marsden Hospital. Epithelioid sarcoma. Rare Prevalent young adults 20–40 years of age Extremities

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Palliative Chemotherapy in Epithelioid Sarcoma

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  1. Palliative Chemotherapy in Epithelioid Sarcoma Robin L Jones, Anastasia Constantinidou, Khin Thway, Cyril Fisher, Omar Al-Muderis, Michelle Scurr, Ian R Judson Sarcoma Unit, Royal Marsden Hospital

  2. Epithelioid sarcoma • Rare • Prevalent young adults • 20–40 years of age • Extremities • Multiple local recurrences • Proximal-type

  3. Methods • Aim to document • Response • Progression-free survival • Prospective database identify • Epithelioid sarcoma patients • Treated with chemotherapy • 1990–2009

  4. Methods • Histological diagnosis confirmed • Response criteria used • RECIST • WHO • Statistical analysis • Median and range were used for continuous variables and proportions (%) for categorical variables • Kaplan-Meier method used to present survival data

  5. Results • 55 epithelioid sarcoma patients • Epithelioid sarcoma comprise <1% of soft tissue sarcomas in database • 20 treated with chemotherapy • 18 males • 2 females

  6. Patient characteristics

  7. Treatment • Surgery for local disease: 16 (80%) • Surgery for metastatic disease: 9 (45%) • Adjuvant radiotherapy: 6 (30%) • Palliative radiotherapy: 8 (40%)

  8. Radiotherapy post chemotherapy • PD on chemotherapy, n=1 • to pelvis • Consolidation post chemotherapy • PR, n=2 • to chest wall • SD, n=3 • to tongue + left arm • to pelvis • to cervical spine

  9. Results • Adjuvant chemotherapy: 4 (20%) • One lost to follow-up • First line chemotherapy • 2 locally advanced • 17 metastatic disease • Metastatic sites • Pulmonary • Soft tissue • Lymph node • Hepatic • Pleura • Brain

  10. First line chemotherapy • One recently completed first-line therapy • PR: 5 (28%) • SD: 8 (44%) • PD: 5 (28%)

  11. First line chemotherapy 19 patients

  12. Proximal-type • Proximal-type • SD, n=5 (56%) • PD, n=4 (44%) • Non-proximal type • PR, n=5 (56%) • SD, n=3 (33%) • PD, n=1 (11%)

  13. First-line chemotherapy • Median PFS: 7 (95%CI, 4-9) months • Median OS: 11 (95%CI, 5-21) months • From diagnosis • Median OS: 33 (95%CI, 28-39) months

  14. Second line chemotherapy 7 patients

  15. Third line chemotherapy • 3 patients

  16. Major toxicity • Adjuvant • Ifosfamide-induced encephalopathy: 1 patient • First-line • Neutropenic sepsis: 2 patients • Second-line • Neutropenic sepsis: 1 patient • Third-line • None

  17. OS from first-line chemotherapy in all soft tissue sarcoma subtypesKaravasilis et al, Cancer 2008: 112; 1585-1591

  18. Conclusion • Epithelioid sarcoma is chemosensitive • Response rate • Progression-free survival

  19. Sue Ashley Cerys Propert-Lewis Alison Dunlop Sam Hackett Elizabeth Barquin Julie Dados Meirion Thomas Andrew Hayes Dirk Strauss Frank Saran Acknowledgments

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