Target therapy for metastatic alveolar soft part sarcoma: a retrospective study with 47 cases.
Target therapy for metastatic alveolar soft part sarcoma: a retrospective study with 47 cases.
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DOI：
10.21037/atm-20-6377
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发表时间：
2020-11
影响因子：
--
通讯作者：
Fang Z
中科院分区：
文献类型：
--
作者：
Liu J;Fan Z;Li S;Gao T;Xue R;Bai C;Zhang L;Tan Z;Fang Z
腺泡状软组织肉瘤（ASPS）是一种移位相关的软组织肿瘤，对传统的细胞毒性药物具有耐药性。本报告旨在比较安洛替尼与帕唑帕尼作为转移性ASPS靶向单药治疗的疗效，并确定药物剂量减少对疾病控制的影响。16例和31例转移性ASPS患者分别在一家机构接受了安洛替尼和帕唑帕尼单药治疗。检索并比较两个治疗组的客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。记录各组内的不良事件（AE）。Kaplan-Meier生存曲线计算药物剂量减少对PFS的影响。安洛替尼组的ORR为31.2%，而帕唑帕尼组为35.5%（P=0.772）。接受安洛替尼治疗的患者中位PFS为23.6个月[95%置信区间（CI），16.2-31.0个月]，但接受帕唑帕尼治疗的患者中位PFS降至13.7个月（95% CI，10.8-16.7个月）（P=0.023）。1例（6.3%）接受安洛替尼治疗的患者和11例（35.5%）接受帕唑帕尼治疗的患者发生了需要减少药物剂量的AE（P=0.029），后者显著降低了患者的PFS（10.5 vs 15.8个月，P=0.012）。在未减少剂量的患者中，安洛替尼在中位PFS方面显示出比帕唑帕尼更大的优势（24.5 vs. 15.8个月，P=0.112）。与帕唑帕尼相比，安洛替尼在ASPS患者中产生了更长的PFS和更低的AE发生率。前一种药剂更常遇到药物剂量减少，影响疾病控制。
Alveolar soft part sarcoma (ASPS) is a translocation-associated soft-tissue tumor resistant to conventional cytotoxic agents. This report aims to compare the efficacy of anlotinib versus pazopanib as targeted monotherapy in metastatic ASPS and to determine the impact of drug dosage reduction on disease control. Sixteen and 31 patients with metastatic ASPS were respectively treated with anlotinib and pazopanib monotherapy at a single institution. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were retrieved and compared between both therapeutic arms. Adverse events (AEs) within each group were recorded. Kaplan-Meier survivorship curves computed the impact of drug dosage reduction on PFS. The anlotinib group showed an ORR of 31.2%, compared to 35.5% in the pazopanib arm (P=0.772). Median PFS was 23.6 months [95% confidence interval (CI), 16.2–31.0 months] in patients treated with anlotinib, but dropped to 13.7 months (95% CI, 10.8–16.7 months) in those managed with pazopanib (P=0.023). One (6.3%) patient on anlotinib and 11 (35.5%) on pazopanib developed AEs requiring drug dosage reduction (P=0.029), which significantly reduced patients’ PFS in the latter setting (10.5 vs. 15.8 months, P=0.012). In patients without dosage reduction, anlotinib showed a bordering advantage than pazopanib on median PFS (24.5 vs. 15.8 months, P=0.112). Compared to pazopanib, anlotinib yielded longer PFS and lower incidence of AEs in ASPS patients. Drug dosage reduction was more frequently encountered with the former agent and affected the disease control.