Long-lasting activity of trabectedin in refractory uterine leiomyosarcoma: a case report.

Abstract

BACKGROUND:

Leiomyosarcoma (LMS) is an aggressive soft tissue sarcoma derived from smooth muscle cells typically of uterine, gastrointestinal or soft tissue origin. The prognosis for this tumor is poor, with survival rates among the lowest of all soft tissue sarcomas. Surgery is the best approach for localized disease. The principal role of chemotherapy is prevalently in the treatment of metastatic disease. Trabectedin, a promising new DNA-damaging agent with a mechanism of action that differs from that of traditional alkylating agents, has been approved in Europe for the treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide,

CASE PRESENTATION:

We report the case of a 53-year-old woman with metastatic well differentiated uterine leiomyosarcoma refractory to multiple treatments who underwent 22 cycles of trabectedin over 30 months, obtaining a partial response according to RECIST (Response Evaluation Criteria in Solid Tumors) criteria, with good tolerability, and maintaining the response for 10 months after trebectedin withdrawal.

CONCLUSION:

This very prolonged response, which persisted after drug discontinuation, suggests that trabectedin exerts an oncostatic effect rather than the cytotoxic one produced by other chemotherapeutic agents. Our experience also raises the question of the best way to evaluate trabectedin efficacy.

• Authors: Alberto Bongiovanni, Nada Riva, Marianna Ricci, Laura Mercatali, Chiara Liverani, Federico La Manna, Alessandro De Vita, Davide Cavaliere, Federica Pieri, Devil Oboldi, Giorgio Maria Verdecchia, Dino Amadori, Toni Ibrahim
• Journal: BMC cancer (BMC Cancer) Vol. 15 Pg. 998 (Dec 22 2015) ISSN: 1471-2407 [Electronic] England
• PMID: 26695071 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents, Alkylating
• Dioxoles
• Tetrahydroisoquinolines
• Trabectedin

Topics

• Antineoplastic Agents, Alkylating (therapeutic use)
• Dioxoles (therapeutic use)
• Female
• Humans
• Leiomyosarcoma (drug therapy)
• Middle Aged
• Tetrahydroisoquinolines (therapeutic use)
• Trabectedin
• Treatment Outcome
• Uterine Neoplasms (drug therapy)