Ten-year experience of pharmacotherapy for soft tissue sarcomas


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Background. Currently, systemic therapy for soft tissue sarcomas is an unresolved problem. It is necessary to evaluate the experience of systemic pharmacotherapy in real clinical practice and determine the important factors that influence the treatment results. Objective. Evaluation of the effectiveness of systemic therapy for patients with soft tissue sarcomas treated in the N.N. Petrov National Medical Research Center of Oncology in 2008-2018 (REPRISA trial). Methods. The study included 123 patients (25.2% - men, 74.8% - women) who underwent chemotherapy: monotherapy (MCT) -20 patients, polychemotherapy (PCT) - 65 patients or immunotherapy with an autologous dendritic cell vaccine (DCV) - 38 patients. The of objective response rate (OR), time to tumor progression (TTP), and overall survival (OS) of the patients were evaluated. Results. During PCT, the OR rate was 20%, the median TTP was 6 months, the median OS was 29.6 months, and one-year OS was 59%. In the DCV group, the OR rate was 2.6%, the median TTP was 4.3 months, the median OS was 20.9 months, and the one-year OS was 42%. In the MCT group, no OR was observed, the median TTP was 2 months, the median OS was 12.4 months, and the one-year OS was 23%. In a multivariate analysis of TTP, a history of MCT or DCV increased the relative risk (RR) of progression to 1.82, and complex treatment reduced RR to 0.519. PCT reduced the risk of progression to 0.33, while the use of DCV reduced the OR of progression to 0.406 (p=0.006). When assessing OS, the risk of death increased with an increase in the stage of the tumor process (p=0.035) and with a history of MCT or DCV (p=0.001). PCT reduced the RR of death to 0.51 (p=0.01). Conclusion. Thus, pharmacotherapy for soft tissue sarcomas, as well as the stage of the disease, is an important factor in determining OS. The use of immunological approaches requires further investigation as a component of the complex treatment of patients with soft tissue sarcomas.

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作者简介

A. Novik

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

T. Nekhaeva

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

A. Semenova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

A. Danilova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

D. Latipova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

N. Pipia

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

G. Teletaeva

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

N. Avdonkina

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

A. Zozulya

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

M. Blokhina

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

Ani Oganesyan

N.N. Petrov National Medical Research Center of Oncology

Email: ani101192@mail.ru
Doctor at the Outpatient Department № 2 of the Clinical Diagnostic Center 68, Leningradskaya str., Pesochny settlement, St. Petersburg 197758, Russian Federation

S. Protsenko

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

I. Baldueva

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

参考

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