RESUMO
BACKGROUND: Soft tissue sarcomas (STSs) are an uncommon and heterogeneous group of tumours. Several drugs and combinations have been used in clinical practice as second-line (2L) and third-line (3L) treatment. The growth modulation index (GMI) has previously been used as an exploratory efficacy endpoint of drug activity and represents an intra-patient comparison. METHODS: We performed a real-world retrospective study including all patients with advanced STS who had received at least 2 different lines of treatment for advanced disease between 2010 and 2020 at a single institution. The objective was to study the efficacy of both 2L and 3L treatments, analysing the time to progression (TTP) and the GMI (defined as the ratio of TTP between 2 consecutive lines of therapy). RESULTS: Eighty-one patients were included. The median TTP after 2L and 3L treatment was 3.16 and 3.06 months, and the median GMI was 0.81 and 0.74, respectively. The regimens most frequently used in both treatments were trabectedin, gemcitabine-dacarbazine, gemcitabine-docetaxel, pazopanib and ifosfamide. The median TTP by each of these regimens was 2.80, 2.23, 2.83, 4.10, and 5.00 months, and the median GMI was 0.78, 0.73, 0.67, 1.08, and 0.94, respectively. In terms of histotype, we highlight the activity (GMI > 1.33) of gemcitabine-dacarbazine in undifferentiated pleomorphic sarcoma (UPS) and in leiomyosarcoma, pazopanib in UPS, and ifosfamide in synovial sarcoma. CONCLUSIONS: In our cohort, regimens commonly used after first-line STS treatment showed only slight differences in efficacy, although we found significant activity of specific regimens by histotype.
Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Humanos , Ifosfamida/uso terapêutico , Estudos Retrospectivos , Desoxicitidina/uso terapêutico , Sarcoma/tratamento farmacológico , Sarcoma/patologia , Gencitabina , Neoplasias de Tecidos Moles/tratamento farmacológico , Neoplasias de Tecidos Moles/patologia , Dacarbazina/uso terapêuticoRESUMO
Gastrointestinal stromal tumor (GIST) is the most common malignant neoplasm of mesenchymal origin, and a paradigmatic model for a successful rational development of targeted therapies in cancer. The introduction of tyrosine kinase inhibitors with activity against KIT/PDGFRA in both localized and advanced stages has remarkably improved the survival in a disease formerly deemed resistant to all systemic therapies. These guidelines are elaborated by the conjoint effort of the Spanish Society of Medical Oncology (SEOM) and the Spanish Sarcoma Research Group (GEIS) and provide a multidisciplinary and updated consensus for the diagnosis and treatment of GIST patients. We strongly encourage that the managing of these patients should be performed within multidisciplinary teams in reference centers.
Assuntos
Tumores do Estroma Gastrointestinal , Sarcoma , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/terapia , Oncologia , Consenso , Receptores Proteína Tirosina QuinasesRESUMO
Primary ovarian Burkitt lymphoma (BL) is a rare neoplasm in adults. We report a 30-year-old woman diagnosed with primary bilateral ovarian BL. She presented features of a twisted ovarian cyst and underwent bilateral salpingo-oophorectomy. The histopathologic evaluation yielded the diagnosis of BL and subsequently she received chemoimmunotherapy with CODOX-M-IVAC plus rituximab (anti-CD20 monoclonal antibody).
Assuntos
Linfoma de Burkitt/diagnóstico , Neoplasias Ovarianas/diagnóstico , Adulto , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Murinos , Antineoplásicos/uso terapêutico , Linfoma de Burkitt/tratamento farmacológico , Feminino , Humanos , Neoplasias Ovarianas/tratamento farmacológico , RituximabRESUMO
There is no standard chemotherapy regimen in advanced gastric cancer with poor performance status and hepatic dysfunction. New chemotherapeutical agents and targeted therapy have demonstrated promising results in terms of efficacy and safety in phase II clinical trials. We report the case of a 68-year-old man with stage IV gastric cancer and severe hepatic dysfunction due to liver metastases treated with a combination of oxaliplatin, 5-fluorouracil and cetuximab.