Abstract | INTRODUCTION: METHODS: All patients with advanced or recurrent uterine leiomyosarcoma who received temozolomide during treatment were retrospectively identified. Relevant clinical and pathologic data were collected and compared. O-Methylguanine DNA methyltransferase expression was assessed by immunohistochemistry and scored by a gynecologic pathologist blinded to clinical outcomes. RESULTS: From 1999 to 2008, 9 cases of leiomyosarcoma were diagnosed; 6 patients received temozolomide. Median follow-up was 54 months (range, 4-114 months). There was 1 patient with complete response, 1 durable partial response (27+ months), 3 stable disease (range, 3-10 months), and 1 progressive disease. Overall, 5 out of 6 patients derived clinical benefit. The patient with a complete response recurred 18 months after her last cycle. Median progression free interval was 15.4 months (95% confidence interval, 9.4-21.4). Two patients died of disease. Temozolomide was well tolerated with no dose-limiting toxicities, and no dose adjustments were required in 64 prescribed cycles. The MGMT expression was inversely correlated with response to temozolomide. Patients with tumors negative for MGMT expression had a median progression free interval of 18.5 months compared with 3 months for those whose tumors were positive, although not statistically significant. CONCLUSIONS:
Temozolomide is an easily administered, well-tolerated chemotherapeutic option in advanced or recurrent uterine leiomyosarcomas with a reasonable response rate. Assessment of MGMT expression may identify a subset of patients that will respond optimally to this therapy.
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Authors | J Stuart Ferriss, Kristen A Atkins, Jason A Lachance, Susan C Modesitt, Amir A Jazaeri |
Journal | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
(Int J Gynecol Cancer)
Vol. 20
Issue 1
Pg. 120-5
(Jan 2010)
ISSN: 1525-1438 [Electronic] England |
PMID | 20130512
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
- Antineoplastic Agents, Alkylating
- Biomarkers, Pharmacological
- Biomarkers, Tumor
- Dacarbazine
- O(6)-Methylguanine-DNA Methyltransferase
- Temozolomide
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Topics |
- Adult
- Antineoplastic Agents, Alkylating
(therapeutic use)
- Biomarkers, Pharmacological
(metabolism)
- Biomarkers, Tumor
(metabolism)
- Dacarbazine
(analogs & derivatives, therapeutic use)
- Disease Progression
- Female
- Follow-Up Studies
- Humans
- Leiomyosarcoma
(diagnosis, drug therapy, metabolism, surgery)
- Middle Aged
- O(6)-Methylguanine-DNA Methyltransferase
(metabolism)
- Prognosis
- Recurrence
- Retrospective Studies
- Temozolomide
- Uterine Neoplasms
(diagnosis, drug therapy, metabolism, surgery)
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