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24.11.2017 | Original Research Article

Phase II Study of Gemcitabine Plus Sirolimus in Previously Treated Patients with Advanced Soft-Tissue Sarcoma: a Spanish Group for Research on Sarcomas (GEIS) Study

verfasst von: Juan Martin-Liberal, Antonio López-Pousa, Javier Martínez-Trufero, Javier Martín-Broto, Ricardo Cubedo, Javier Lavernia, Andrés Redondo, José Antonio López-Martín, Nùria Mulet-Margalef, Xavier Sanjuan, Òscar M. Tirado, Xavier Garcia-del-Muro

Erschienen in: Targeted Oncology | Ausgabe 1/2018

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Abstract

Background

Gemcitabine plus sirolimus enhances apoptosis in vitro and increases anti-tumor efficacy in vivo in soft-tissue sarcoma (STS) models.

Objective

The objective of this study was to evaluate the activity and toxicity of the combination of gemcitabine plus sirolimus in patients with STS after failure of standard chemotherapy.

Patients and Methods

Advanced STS patients, previously treated with doxorubicin and/or ifosfamide, were included in this single-arm phase II study. Patients received gemcitabine 800 mg/m² intravenously (iv) at 10 mg/m²/min on days 1 and 8 every 3 weeks plus sirolimus 5 mg daily orally (po). After enrolment of the first 12 patients, the study protocol was amended due to toxicity and the starting dose of sirolimus was reduced to 3 mg daily po. Archival tumor samples were analyzed for extracellular signal-regulated kinase 1 and 2 (ERK1/2) expression and correlated with outcome. The primary endpoint was progression-free rate (PFR) at 3 months.

Results

From May 2012 to May 2013, 28 patients were enrolled at eight centers. PFR at 3 and 6 months was 44% and 20%, respectively, with 12 patients being free of progression at 3 months. Median progression-free survival (PFS) was 1.85 months (95% confidence interval [CI] 0.73–2.97) and median overall survival (OS) was 9.2 months (95% CI 5.8–12.5). No responses were observed. The most common grade 3–4 hematologic toxicities were neutropenia (48%) and leukopenia (41%) and the most frequent grade 3 non-hematologic toxicities were infection (18.5%), transaminitis (15%), fatigue (11%), and pneumonitis (11%). ERK1/2 expression was significantly correlated with PFS (p = 0.026).

Conclusions

The combination of gemcitabine and sirolimus is an active treatment in STS. Further investigation is warranted. ClinicalTrials.gov identifier: NCT01684449.

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Titel: Phase II Study of Gemcitabine Plus Sirolimus in Previously Treated Patients with Advanced Soft-Tissue Sarcoma: a Spanish Group for Research on Sarcomas (GEIS) Study
verfasst von: Juan Martin-Liberal
Antonio López-Pousa
Javier Martínez-Trufero
Javier Martín-Broto
Ricardo Cubedo
Javier Lavernia
Andrés Redondo
José Antonio López-Martín
Nùria Mulet-Margalef
Xavier Sanjuan
Òscar M. Tirado
Xavier Garcia-del-Muro
Publikationsdatum: 24.11.2017
Verlag: Springer International Publishing
Erschienen in: Targeted Oncology / Ausgabe 1/2018
Print ISSN: 1776-2596
Elektronische ISSN: 1776-260X
DOI: https://doi.org/10.1007/s11523-017-0539-9

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Phase II Study of Gemcitabine Plus Sirolimus in Previously Treated Patients with Advanced Soft-Tissue Sarcoma: a Spanish Group for Research on Sarcomas (GEIS) Study

Abstract

Background

Objective

Patients and Methods

Results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Background

Objective

Patients and Methods

Results

Conclusions

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