Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis
Background: The prognosis of patients with advanced soft tissue sarcoma (STS) remains dismal. Trofosfamide (TRO) has been proposed as a well-tolerated oral maintenance therapy. This retrospective analysis aims to determine the value of this therapy. Methods: Fifty-nine patients with advanced STS wh...
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Medical Journals Sweden
2025-01-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42356 |
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| author | Anton Burkhard-Meier Vera Valerie Rechenauer Luc M. Berclaz Vindi Jurinovic Markus Albertsmeier Hans Roland Dürr Sinan E. Güler Michael Hoberger Alexander Klein Thomas Knösel Wolfgang G. Kunz Nina-Sophie Schmidt-Hegemann Michael von Bergwelt-Baildon Lars H. Lindner Dorit Di Gioia |
| author_facet | Anton Burkhard-Meier Vera Valerie Rechenauer Luc M. Berclaz Vindi Jurinovic Markus Albertsmeier Hans Roland Dürr Sinan E. Güler Michael Hoberger Alexander Klein Thomas Knösel Wolfgang G. Kunz Nina-Sophie Schmidt-Hegemann Michael von Bergwelt-Baildon Lars H. Lindner Dorit Di Gioia |
| author_sort | Anton Burkhard-Meier |
| collection | DOAJ |
| description | Background: The prognosis of patients with advanced soft tissue sarcoma (STS) remains dismal. Trofosfamide (TRO) has been proposed as a well-tolerated oral maintenance therapy. This retrospective analysis aims to determine the value of this therapy.
Methods: Fifty-nine patients with advanced STS who received TRO maintenance therapy between 2016 and 2022 were reviewed and analysed regarding clinical parameters and outcomes.
Results: The median age was 48 years; the most common histological subtype was synovial sarcoma (n = 22, 37%), and 71% of patients (n = 42) presented with metastatic disease. No radiological evidence of disease (NED) before the start of maintenance was reported in 36% of patients (n = 21). The median follow-up was 38.2 months with a median maintenance duration of 9.0 months. The median event-free survival (EFS) and overall survival (OS) were 9.5 and 33.2 months, respectively. In metastatic patients achieving NED before the initiation of TRO, the median EFS was 29.4 months, while the median OS was not reached. In metastatic patients with anthracycline + ifosfamide (AI) as first-line induction therapy without prior metastasis-directed local therapy, the median EFS and OS from the start of AI were 13.9 and 26.8 months, respectively. Multivariate analysis of the overall cohort demonstrated that NED before the start of maintenance was significantly associated with a prolonged EFS (p = 0.024, hazard ratio [HR] = 0.26), and G2 histology correlated with longer OS (p = 0.030, HR = 0.16, reference: G3).
Interpretation: Oral maintenance therapy with TRO appears to improve outcomes in patients with advanced STS. Metastatic patients who achieve NED through prior metastasectomy may particularly benefit from TRO maintenance.
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| format | Article |
| id | doaj-art-3b3a2629c02a4457a974a06a3c1b241c |
| institution | DOAJ |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-3b3a2629c02a4457a974a06a3c1b241c2025-08-20T02:42:29ZengMedical Journals SwedenActa Oncologica1651-226X2025-01-016410.2340/1651-226X.2025.42356Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysisAnton Burkhard-Meier0https://orcid.org/0009-0002-9801-3530Vera Valerie Rechenauer1Luc M. Berclaz2Vindi Jurinovic3Markus Albertsmeier4Hans Roland Dürr5Sinan E. Güler6Michael Hoberger7Alexander Klein8Thomas Knösel9Wolfgang G. Kunz10Nina-Sophie Schmidt-Hegemann11Michael von Bergwelt-Baildon12Lars H. Lindner13Dorit Di Gioia14Comprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany ; Bavarian Cancer Research Center (BZKF), Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, Germany; German Cancer Consortium (DKTK), partner site Munich, Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, University Hospital, LMU Munich, Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Department of Orthopedics and Trauma Surgery, University Hospital, LMU Munich, Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Department of Orthopedics and Trauma Surgery, University Hospital, LMU Munich, Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Institute of Pathology, University Hospital, LMU Munich, Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, GermanyBavarian Cancer Research Center (BZKF), Munich, Germany; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, Germany; German Cancer Consortium (DKTK), partner site Munich, Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyComprehensive Cancer Center Munich and Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyBackground: The prognosis of patients with advanced soft tissue sarcoma (STS) remains dismal. Trofosfamide (TRO) has been proposed as a well-tolerated oral maintenance therapy. This retrospective analysis aims to determine the value of this therapy. Methods: Fifty-nine patients with advanced STS who received TRO maintenance therapy between 2016 and 2022 were reviewed and analysed regarding clinical parameters and outcomes. Results: The median age was 48 years; the most common histological subtype was synovial sarcoma (n = 22, 37%), and 71% of patients (n = 42) presented with metastatic disease. No radiological evidence of disease (NED) before the start of maintenance was reported in 36% of patients (n = 21). The median follow-up was 38.2 months with a median maintenance duration of 9.0 months. The median event-free survival (EFS) and overall survival (OS) were 9.5 and 33.2 months, respectively. In metastatic patients achieving NED before the initiation of TRO, the median EFS was 29.4 months, while the median OS was not reached. In metastatic patients with anthracycline + ifosfamide (AI) as first-line induction therapy without prior metastasis-directed local therapy, the median EFS and OS from the start of AI were 13.9 and 26.8 months, respectively. Multivariate analysis of the overall cohort demonstrated that NED before the start of maintenance was significantly associated with a prolonged EFS (p = 0.024, hazard ratio [HR] = 0.26), and G2 histology correlated with longer OS (p = 0.030, HR = 0.16, reference: G3). Interpretation: Oral maintenance therapy with TRO appears to improve outcomes in patients with advanced STS. Metastatic patients who achieve NED through prior metastasectomy may particularly benefit from TRO maintenance. https://medicaljournalssweden.se/actaoncologica/article/view/42356Soft Tissue SarcomaTrofosfamideMaintenanceSystemic TherapyMetastasis |
| spellingShingle | Anton Burkhard-Meier Vera Valerie Rechenauer Luc M. Berclaz Vindi Jurinovic Markus Albertsmeier Hans Roland Dürr Sinan E. Güler Michael Hoberger Alexander Klein Thomas Knösel Wolfgang G. Kunz Nina-Sophie Schmidt-Hegemann Michael von Bergwelt-Baildon Lars H. Lindner Dorit Di Gioia Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis Acta Oncologica Soft Tissue Sarcoma Trofosfamide Maintenance Systemic Therapy Metastasis |
| title | Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis |
| title_full | Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis |
| title_fullStr | Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis |
| title_full_unstemmed | Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis |
| title_short | Maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma – a retrospective single-centre analysis |
| title_sort | maintenance treatment with trofosfamide in patients with advanced soft tissue sarcoma a retrospective single centre analysis |
| topic | Soft Tissue Sarcoma Trofosfamide Maintenance Systemic Therapy Metastasis |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42356 |
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