Altmışbeş Yaş Üstü Metastatik Yumuşak Doku Sarkom Hastalarında Pazopanib Tedavisinin Etkinliğinin Retrospektif Değerlendirilmesi.

Yıl 2019, Cilt: 45 Sayı: 1, 83 - 86, 01.04.2019

Erdem Çubukçu , Birol Ocak

https://doi.org/10.32708/uutfd.503875

Öz

Yumuşak doku sarkomları (YDS) mezenşimal
hücrelerden köken alan tümörlerin nadir ve heterojen grububudur ve tüm erişkin
kanserlerin yaklaşık %1 ini oluşturmaktadır. YDS lerin 50 den fazla farklı
histolojik tipi mevcuttur. Pazopanib, Vasküler endotelyal büyüme faktörü reseptör 1
(VEGFR-1), VEGFR-2, VEGFR-3, trombosit kökenli büyüme faktörü a
(PDGFR-a) ve c-kit bloke eden oral kullanılan tirozin kinaz inhibitörüdür.
İlerlemiş
yumuşak doku sarkoması olan yaşlı hastalarda oral multi-tirozin kinaz
anjiyogenez inhibitörü pazopanib ile tedavi sonuçlarını geriye dönük olarak
inceledik. Medyan yaş 72 (65-79) olan toplam 13 hasta dosyası Ocak 2014-Eylül 2018
arasında retrospektif olarak incelendi. Kapesitabin ve Pazopanib
tedavisi kemoterapi sonrasında progrese olan yumuşak doku sarkomlu yaşlı
hastalarda etkili ve iyi tolere edilmiştir.

Anahtar Kelimeler

Sarkom, Vasküler endotelyal büyüme faktör reseptör, anjiyogenez

A Retrospective Evaluation of the Efficacy of Pazopanib Treatment in Patients with Metastatic Soft Tissue Sarcoma over 65 Years

Öz

Soft tissue sarcomas (STS) are a rare and
heterogeneous group of tumors that originate from mesenchymal cells and account
for 1% of all adult malignancies. STS is comprised of more
than 50 different histological subtypes. The primary treatments
of STS are surgery and radiotherapy. Pazopanib is an
oral-used tyrosine kinase inhibitor that blocks vascular endothelial growth
factor receptor 1 (VEGFR-1), VEGFR-2, VEGFR-3 platelet-derived growth factor
receptor (PDGFR-a), PDGFR-a, and c-kit. We retrospectively
reviewed outcomes of treatment with pazopanib, an oral multi-tyrosine kinase
angiogenesis inhibitor, in oldest patients with advanced soft tissue sarcoma. A total of 13 patients with a median age of 72
(65-79)  were evaluated retrospectively
in between January 2014 and September 2018. Pazopanib therapy is effective and
well tolerated in oldest patients with STS who had progressive disease after chemotherapy.

Anahtar Kelimeler

Sarcoma, vascular endothelial growth factor receptor, angiogenesis

Kaynakça

• 1. Clark MA, Fisher C, Judson I, et al. Soft-tissue sarcomas in adults. N Engl J Med 2005;353:701-11.
• 2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin 2012;62(1):10–29.
• 3. Fletcher CD HP, Mertens F, Bridge J. WHO Classification of Tumours of Soft Tissue and Bone. 4th ed. Lyon, France: IARC Press; 2013.
• 4. Zager GK, Ballo MT, Pesters PW, et al. Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy; an analysis of 1225 patients. Cancer 2003;97:2530-43.
• 5. Le Cesne A, Blay JY, Judson I, et al. Phase II study of ET-743 in advanced soft tissue sarcomas: a European Organisation for the Research and Treatment of Cancer (EORTC) soft tissue and bone sarcoma group trial. J Clin Oncol 2005; 23: 576–84.
• 6. Casali PG, Blay JY, ESMO/CONTICANET/EUROBONET Consensus Panel of Experts. Soft tissue sarcomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 5 (suppl): 198–203.
• 7. Judson I, Verweij J, Gelderblom H, Hartmann JT, Schoffski P, Blay JY, et al. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol 2014;15(4):415–23.
• 8. Maki RG, Wathen JK, Pater SR, et al. Randomised phase 2 study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of Sarcoma Alliance for Research Trough Collaboration Study 002. J Clin Oncol 2007; 25: 2755–63.
• 9. Maki RG. Gemcitabine and docetaxel in metastatic sarcoma: past, present and future. Oncologist 2007; 12: 999–1006
• 10.Schutz FA, Choueiri TK, Sternberg CN. Pazopanib: clinical development of a potent anti-angiogenic drug. Crit Rev Oncol Hematol 2011; 77: 163–71.
• 11. Sleijfer S, van der Graaf WT, Blay JY. Angiogenesis inhibition in non-GIST soft tissue sarcomas. Oncologist 2008; 13: 1193–200.
• 12. DuBois S, Demetri G. Markers of angiogenesis and clinical features in patients with sarcoma. Cancer 2007; 109: 813–19.
• 13. Sleijfer S, Ray-Coquard I, Papai Z, et al. Pazopanib, a multikinase angiogenesis inhibitor, in patients with relapsed or refractory advanced soft tissue sarcoma: a phase II study from the European organisation for research and treatment of cancer-soft tissue and bone sarcoma group (EORTC study 62043). J Clin Oncol 2009; 27: 3126–32.
• 14. Scurr M. Histology driven chemotherapy in soft tissue sarcomas. Cur Treat Opt Oncol 2011; 12: 32–45.
• 15. Verweij J, Casali PG, Zalcberg J, et al. Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib:randomised trial. Lancet 2004; 364: 1127–34.
• 16. George S, Merriam P, Maki RG, et al. Multicenter phase II trial of sunitinib in the treatment of nongastrointestinal stromal tumor sarcomas. J Clin Oncol 2009; 27: 3154–60
• 17. Hirata T, Yonemori K, Ando M, et al. Efficacy of taxane regimens in patients with metastatic angiosarcoma. Eur J Dermatol. 2011;21(4):539–45.
• 18. Italiano A, Cioffi A, Penel N, et al. Comparison of doxorubicin and weekly paclitaxel efficacy in metastatic angiosarcomas. Cancer. 2012;118(13):3330–6.
• 19. van der Graaf WT, Blay JY, Chawla SP, et al . EORTC Soft Tissue and Bone Sarcoma Group; PALETTE study group. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 2012;19;379(9829):1879-86.
• 20. Nakamura T, Matsumine A, Kawai A, et al. The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma: A Japanese Musculoskeletal Oncology Group (JMOG) study. Cancer. 2016;1;122(9):1408-16.
• 21. Sahin B. Yumuşak doku sarkomlarında kemoterapi. Türk Onkoloji Dergisi 2015;30(1):62-8.