Familial adenomatosis polyposis-related desmoid tumours treated with low-dose chemotherapy: results from an international, multi-institutional, retrospective analysis.

Abstract

INTRODUCTION:

Desmoid tumour (DT) is a locally aggressive fibroblastic proliferative disease representing the most common extraintestinal manifestation of familial adenomatosis polyposis (FAP). As data on the activity of chemotherapy in these patients are limited, we examined the outcomes of patients treated with low-dose methotrexate (MTX)+vinca alkaloids (vinorelbine or vinblastine).

PATIENTS AND METHODS:

We retrospectively reviewed clinical and outcome data from all patients with confirmed FAP-associated DTs treated with weekly MTX+vinca alkaloids in seven European sarcoma reference centres between January 2000 and December 2018. Radiological responses were assessed using RECIST V.1.0 and V.1.1. The Kaplan-Meier method associated to the log-rank test was used to estimate and compare survival curves.

RESULTS:

We identified 37 patients (median age 29 years, range 7-44). According to RECIST, 20/37 (54.1%) patients achieved partial response (PR), 15/37 (40.5%) patients had stable disease and 2/37 (5.4%) had progressive disease as best response. Overall, the median progression-free survival (PFS) was 6.5 years (range, 0.3-12.1 years). In the subset of patients achieving PR as best response, the median PFS was not reached. In a subset of 11 patients with progressive disease offered MTX+vinca alkaloids rechallenge (after chemotherapy withdrawal following prolonged disease control), the disease control rate was 100%, resulting in a median PFS after rechallenge of 5.8 years.

CONCLUSIONS:

This is the largest series on the activity of low-dose chemotherapy in patients with FAP-related DT. In this population, MTX+vinca alkaloids is an active combination, as already reported in patients with sporadic DT.

• Authors: Andrea Napolitano, Salvatore Provenzano, Chiara Colombo, Marco Vitellaro, Antonella Brunello, Giuseppe Badalamenti, Margherita Nannini, Toni Ibrahim, Peter Hohenberger, Silvia Gasperoni, Spyridon Gennatas, Robin L Jones, Nadia Hindi, Javier Martin-Broto, Mariella Spalato Ceruso, Marianna Silletta, Angelo Paolo Dei Tos, Alessandro Gronchi, Silvia Stacchiotti, Daniele Santini, Giuseppe Tonini, Elena Palassini, Bruno Vincenzi
• Journal: ESMO open (ESMO Open) Vol. 5 Issue 1 (01 2020) ISSN: 2059-7029 [Electronic] England
• PMID: 31958289 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.

Topics

• Adenomatous Polyposis Coli (drug therapy)
• Adolescent
• Adult
• Child
• Female
• Humans
• Retrospective Studies
• Young Adult