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Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma

Background. Leiomyosarcomas (LMS) represent a heterogeneous subset of soft tissue sarcomas. Factors influencing prognosis for patients with metastatic extrauterine LMS (euLMS) are not well described. Limited data are available regarding responses to systemic therapy. Methods. We collected clinical a...

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Autores principales: Shoushtari, A. N., Landa, J., Kuk, D., Sanchez, A., Lala, B., Schmidt, N., Okoli, C., Chi, P., Dickson, M. A., Gounder, M. M., Keohan, M. L., Crago, A. M., Tap, W. D., D'Angelo, S. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4903146/
https://www.ncbi.nlm.nih.gov/pubmed/27313489
http://dx.doi.org/10.1155/2016/3547497
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author Shoushtari, A. N.
Landa, J.
Kuk, D.
Sanchez, A.
Lala, B.
Schmidt, N.
Okoli, C.
Chi, P.
Dickson, M. A.
Gounder, M. M.
Keohan, M. L.
Crago, A. M.
Tap, W. D.
D'Angelo, S. P.
author_facet Shoushtari, A. N.
Landa, J.
Kuk, D.
Sanchez, A.
Lala, B.
Schmidt, N.
Okoli, C.
Chi, P.
Dickson, M. A.
Gounder, M. M.
Keohan, M. L.
Crago, A. M.
Tap, W. D.
D'Angelo, S. P.
author_sort Shoushtari, A. N.
collection PubMed
description Background. Leiomyosarcomas (LMS) represent a heterogeneous subset of soft tissue sarcomas. Factors influencing prognosis for patients with metastatic extrauterine LMS (euLMS) are not well described. Limited data are available regarding responses to systemic therapy. Methods. We collected clinical and pathologic information for all patients with metastatic euLMS seen at Memorial Sloan Kettering Cancer Center between 1989 and 2012. Objective responses to first-line therapy were analyzed for a subset of patients with available baseline and on-treatment imaging using RECIST 1.1. Results. 215 patients with metastatic euLMS had a median overall survival (OS) of 2.6 years from the time of metastasis. Older age, male sex, and ≥3 initial sites of metastasis were associated with worse OS on multivariate analysis. Objective response rate (ORR) in N = 113 was 19% overall and 25%, 26%, and 25% for gemcitabine, gemcitabine plus docetaxel, and anthracycline-alkylator combinations. Patients whose tumors objectively responded to first-line therapy had a lower risk of death versus those who did not (Hazard Ratio 0.46; 95% CI: 0.26–0.79, p = 0.005). Conclusions. Anthracycline- and gemcitabine-based regimens have similar activity in this cohort of euLMS. Prognostic factors for OS include older age, male sex, and ≥3 initial sites.
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spelling pubmed-49031462016-06-16 Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma Shoushtari, A. N. Landa, J. Kuk, D. Sanchez, A. Lala, B. Schmidt, N. Okoli, C. Chi, P. Dickson, M. A. Gounder, M. M. Keohan, M. L. Crago, A. M. Tap, W. D. D'Angelo, S. P. Sarcoma Research Article Background. Leiomyosarcomas (LMS) represent a heterogeneous subset of soft tissue sarcomas. Factors influencing prognosis for patients with metastatic extrauterine LMS (euLMS) are not well described. Limited data are available regarding responses to systemic therapy. Methods. We collected clinical and pathologic information for all patients with metastatic euLMS seen at Memorial Sloan Kettering Cancer Center between 1989 and 2012. Objective responses to first-line therapy were analyzed for a subset of patients with available baseline and on-treatment imaging using RECIST 1.1. Results. 215 patients with metastatic euLMS had a median overall survival (OS) of 2.6 years from the time of metastasis. Older age, male sex, and ≥3 initial sites of metastasis were associated with worse OS on multivariate analysis. Objective response rate (ORR) in N = 113 was 19% overall and 25%, 26%, and 25% for gemcitabine, gemcitabine plus docetaxel, and anthracycline-alkylator combinations. Patients whose tumors objectively responded to first-line therapy had a lower risk of death versus those who did not (Hazard Ratio 0.46; 95% CI: 0.26–0.79, p = 0.005). Conclusions. Anthracycline- and gemcitabine-based regimens have similar activity in this cohort of euLMS. Prognostic factors for OS include older age, male sex, and ≥3 initial sites. Hindawi Publishing Corporation 2016 2016-05-29 /pmc/articles/PMC4903146/ /pubmed/27313489 http://dx.doi.org/10.1155/2016/3547497 Text en Copyright © 2016 A. N. Shoushtari et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Shoushtari, A. N.
Landa, J.
Kuk, D.
Sanchez, A.
Lala, B.
Schmidt, N.
Okoli, C.
Chi, P.
Dickson, M. A.
Gounder, M. M.
Keohan, M. L.
Crago, A. M.
Tap, W. D.
D'Angelo, S. P.
Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title_full Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title_fullStr Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title_full_unstemmed Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title_short Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma
title_sort overall survival and response to systemic therapy in metastatic extrauterine leiomyosarcoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4903146/
https://www.ncbi.nlm.nih.gov/pubmed/27313489
http://dx.doi.org/10.1155/2016/3547497
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