OBJECTIVE: Characterize real-world treatment patterns and survival in Germany for patients with advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy.
METHODS: German physicians completed a web-based medical record review for patients ≥18 years old who had received ≥1 line of systemic therapy for advanced STS (other than Kaposi's sarcoma or gastrointestinal stromal tumors) between 1/1/2005 and 20/2/2014. Physicians reported patients’ clinical characteristics, treatments and outcomes. Data were summarized overall, by line of therapy, and for histological subtypes.
RESULTS: Forty physicians (primarily practicing in academic hospitals (58%) or cancer centers (28%)) provided data for 204 patients. Physicians reported that 10% (median) of the patients in their practices with advanced STS did not receive any systemic cancer-directed therapy and were thus ineligible for this study. Patients' mean age at advanced STS diagnosis was 57.4 (SD=11.0) years, and 64% were male. The most frequent histologic subtypes were leiomyosarcoma (32%), liposarcoma (11%), and rhabdomyosarcoma (10%). Seventy-seven percent of patients had stage IV STS at initial diagnosis; the remainder progressed in an average of 23 (SD=23) months. Forty percent of patients had >1 and 6% had >2 lines of therapy. The five most frequent first-line chemotherapy regimens were doxorubicin (53%), doxorubicin/ifosfamide/mesna (17%), docetaxel/gemcitabine (13%), paclitaxel (4%), and dacarbazine/ifosfamide/mesna (3%); in second-line they were ifosfamide/mesna (42%), docetaxel/gemcitabine (20%), pazopanib (15%), doxorubicin (9%), and trabectedin (5%). During first-line treatment, response rate was an average of 39%, with the highest rate for patients receiving dacarbazine/ifosfamide/mesna (50%; N=6) and the lowest rate for paclitaxel users (13%; N=8). Median survival estimates from start of first- and second-line therapy were 13 (Q1:Q3=8:31) and 19 (Q1:Q3=11: Q3 not estimable) months, respectively.
CONCLUSIONS: Results from this retrospective medical record review point to modest differentiation among existing therapies and a need for futher improvements in advanced STS treatment options in Germany.
