Evaluation of Novel Targeted Therapies in Aggressive Biology Sarcoma Patients after progression from US FDA approved Therapies

Vivek Subbiah, Kenneth R Hess, Muhammad Rizwan Khawaja, Michael J Wagner, Chad Tang, Aung Naing, Siqing Fu, Filip Janku, Sarina Piha-Paul, Apostolia M Tsimberidou, Cynthia E Herzog, Joseph A Ludwig, Shreyaskumar Patel, Vinod Ravi, Robert S Benjamin, Funda Meric-Bernstam, David S Hong, Vivek Subbiah, Kenneth R Hess, Muhammad Rizwan Khawaja, Michael J Wagner, Chad Tang, Aung Naing, Siqing Fu, Filip Janku, Sarina Piha-Paul, Apostolia M Tsimberidou, Cynthia E Herzog, Joseph A Ludwig, Shreyaskumar Patel, Vinod Ravi, Robert S Benjamin, Funda Meric-Bernstam, David S Hong

Abstract

Prognosis of patients with advanced sarcoma after progression from FDA approved therapies remains grim. In this study, clinical outcomes of 100 patients with advanced sarcoma who received treatment on novel targeted therapy trials were evaluated. Outcomes of interest included best response, clinical benefit rate, progression-free survival (PFS) and overall survival (OS). Median patient age was 48 years (range 14-80). Patients had received a median of 2 prior lines of systemic treatment. Phase I treatments were anti-VEGF-based (n = 45), mTOR inhibitor-based (n = 15), and anti-VEGF + mTOR inhibitor-based (n = 17) or involved other targets (n = 23). Best responses included partial response (n = 4) and stable disease (n = 57). Clinical benefit rate was 36% (95% confidence interval 27-46%). Median OS was 9.6 months (95% Confidence Interval 8.1-14.2); median PFS was 3.5 months (95% Confidence Interval 2.4-4.7). RMH prognostic score of 2 or 3 was associated with lower median OS (log-rank p-value < 0.0001) and PFS (log-rank p-value 0.0081). Receiving cytotoxic chemotherapy as part of phase I trial was also associated with shorter median OS (log-rank p-value 0.039). Patients with advanced sarcoma treated on phase I clinical trials had a clinical benefit rate of 36% and RMH score predicted survival.

Figures

Figure 1
Figure 1
Overall survival (A) and Progression-free survival (PFS) among sarcoma patients enrolled on phase I trials.
Figure 2
Figure 2
Overall survival (A) and Progression-free survival (PFS) among sarcoma patients enrolled on phase I trials with respect to Royal Marsden Hospital prognostic score.

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Source: PubMed

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