A Growth Modulation Index-Based GEISTRA Score as a New Prognostic Tool for Trabectedin Efficacy in Patients with Advanced Soft Tissue Sarcomas: A Spanish Group for Sarcoma Research (GEIS) Retrospective Study
Por:
Martinez-Trufero, J, De Sande-Gonzalez, LM, Luna, P, Martin-Broto, J, Alvarez, R, Marquina, G, Diaz-Beveridge, R, Poveda, A, Cano, JM, Cruz-Jurado, J, Pousa, AL, Salgado, MAV, Valverde-Morales, CM, Sevilla, I, Martinez-Garcia, J, Rubio-Casadevall, J, De Juan, A, Carrasco, JA, Moura, DS, Gurruchaga-Sotes, I, Gutierrez, A
Publicada:
1 feb 2021
Resumen:
Simple Summary
Soft tissue sarcomas (STS) are an uncommon and heterogeneous group of tumors, with scarce options for treatment in advanced cases. There is no consensus regarding which is the best treatment sequence for these patients. Although trabectedin is an approved drug for STS treatment, after progression to anthracyclines, the clinical profile of the patients that most benefit from this drug it is not defined. We have retrospectively analyzed a sample of 357 nonselected sarcoma patients from real-world experience, treated homogeneously with trabectedin, confirming and validating results from previous clinical trials and other retrospective studies. After analyzing clinical prognostic factors, we selected those which predicted a better growth modulation index (GMI > 1.33), and we defined the GEISTRA score, an easy to obtain and reproducible clinical tool, that can help us to optimize the use of trabectedin in advanced sarcoma patients.
The aim of this study was to identify an easily reliable prognostic score that selects the subset of advanced soft tissue sarcoma (ASTS) patients with a higher benefit with trabectedin in terms of time to progression and overall survival. A retrospective series of 357 patients with ASTS treated with trabectedin as second- or further-line in 19 centers across Spain was analyzed. First, it was confirmed that patients with high growth modulation index (GMI > 1.33) were associated with the better clinical outcome. Univariate and multivariate analyses were performed to identify factors associated with a GMI > 1.33. Thus, GEISTRA score was based on metastasis free-interval (MFI <= 9.7 months), Karnofsky < 80%, Non L-sarcomas and better response in the previous systemic line. The median GMI was 0.82 (0-69), with 198 patients (55%) with a GMI < 1, 41 (11.5%) with a GMI 1-1.33 and 118 (33.1%) with a GMI > 1.33. The lowest GEISTRA score showed a median of time-to-progression (TTP) and overall survival (OS) of 5.7 and 19.5 months, respectively, whereas it was 1.8 and 3.1 months for TTP and OS, respectively, for the GEISTRA 4 score. This prognostic tool can contribute to better selecting candidates for trabectedin treatment in ASTS.
Filiaciones:
Martinez-Trufero, J:
Hosp Univ Miguel Servet, Med Oncol Dept, Zaragoza 50009, Spain
De Sande-Gonzalez, LM:
Complejo Asistencial Univ Leon, Med Oncol Dept, Leon 24008, Spain
Luna, P:
Hosp Univ Son Espases, Med Oncol Dept, Palma De Mallorca 07010, Spain
Martin-Broto, J:
Hosp Univ Virgen del Rocio, Inst Biomed Sevilla, Med Oncol Dept, IBiS, Seville 41013, Spain
US, CSIC, HUVR, Seville 41013, Spain
Alvarez, R:
Hosp Univ Gregorio Maranon, Med Oncol Dept, Madrid 28009, Spain
Marquina, G:
Hosp Univ Clin San Carlos, Med Oncol Dept, Madrid 28040, Spain
Diaz-Beveridge, R:
Hosp Politecn La Fe, Med Oncol Dept, Valencia 46026, Spain
Poveda, A:
Inst Valenciano Oncol, Med Oncol Dept, Valencia 46007, Spain
Cano, JM:
Hosp Gen Ciudad Real, Med Oncol Dept, Ciudad Real 13005, Spain
Cruz-Jurado, J:
Hosp Univ Canarias, Med Oncol Dept, Santa Cruz De Tenerife 38320, Spain
Pousa, AL:
Hosp Univ Santa Creu & St Pau, Med Oncol Dept, Barcelona 08001, Spain
Salgado, MAV:
Hosp Univ Ramon y Cajal, Med Oncol Dept, RYCIS, CIBERONC, Madrid 28034, Spain
Valverde-Morales, CM:
Hosp Univ Vall DHebron, Med Oncol Dept, Barcelona 08035, Spain
Sevilla, I:
Hosp Univ Reg & Virgen de la Victoria Malaga, Inst Invest Biomed Malaga IBIMA, Med Oncol Dept, Invest Clin & Traslac Canc, Malaga 29010, Spain
Martinez-Garcia, J:
Hosp Virgen Arrixaca, Med Oncol Dept, Murcia 30120, Spain
Rubio-Casadevall, J:
Inst Catalan Oncol, Med Oncol Dept, Girona 17007, Spain
De Juan, A:
Hosp Marques de Valdecilla, Med Oncol Dept, Santander 39008, Spain
Carrasco, JA:
Hosp Alvaro Cunqueiro, Med Oncol Dept, Vigo 36213, Spain
Moura, DS:
US, CSIC, HUVR, Seville 41013, Spain
Inst Biomed Sevilla, IBiS, Seville 41013, Spain
Gurruchaga-Sotes, I:
Hosp Univ Miguel Servet, Med Oncol Dept, Zaragoza 50009, Spain
Gutierrez, A:
Hosp Univ Son Espases, Hematol Dept, Palma De Mallorca 07010, Spain
gold, Green Published
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