OBJECTIVE: To characterize real-world treatment patterns and survival in France for patients with advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy.
METHODS: Physicians based in France completed a retrospective web-based medical record review for patients ≥18 years old who received ≥1 line of systemic therapy for advanced STS (other than Kaposi's sarcoma or gastrointestinal stromal tumors) between 1/1/2005 and 15/8/2015. Patient demographic and clinical characteristics (age; histological subtype), treatments (regimen[s]; dates), and clinical outcomes (progression; death) were recorded. Results were summarized overall, by line of therapy, and by histological subtype.
RESULTS: Thirty-five physicians in France provided data for 201 patients. Physicians reported on average that 9% of patients with advanced STS in their practices did not receive systemic cancer-directed therapy. Patients' mean age at advanced STS diagnosis was 57.9 (SD=12.6) years, with 52% female. The most frequent histologic subtypes were leiomyosarcoma (28%), liposarcoma (12%), and vascular sarcoma (10%). Fifty-two percent of patients had stage IV STS at initial diagnosis. Fifty-four percent of patients received >1 and 23% had >2 lines of therapy. The four most common 1st-line chemotherapy regimens were doxorubicin and doxorubicin/ifosfamide (both 28%), epirubicin/ifosfamide (8%) and trabectedin (5%); in 2nd-line they were trabectedin (19%), pazopanib (15%), docetaxel/gemcitabine and ifosfamide (both 14%). During 1st-line treatment, response rate was an average of 45%, with the highest rate for patients receiving trabectedin (64%; N=11) and the lowest rate for patients receiving doxorubicin (37%; N=57). Most patients received an additional line of therapy following 1st-line treatment with doxorubicin (60%) and doxorubicin/ifosfamide (79%), whereas “alive but no further therapy” was the most common status following 1st-line treatment with epirubicin/ifosfamide (65%), trabectedin (82%), and paclitaxel (90%). Median (95% CI) survival estimates from start of 1st- and 2nd-line therapy were 23 (17:26) and 19 (14:28) months, respectively.
CONCLUSIONS: Results from this retrospective medical record review illustrate substantial heterogeneity in treatment of patients with advanced STS in France. Continued advances in treatment options for advanced STS in France remain important.
