Pseudoprogression in patients with uterine leiomyosarcoma treated with first-line single-agent doxorubicin.

Autor: Howroyd LR; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. Electronic address: Rose.Howroyd@nhs.net., Cornell I; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. Electronic address: Isabel.Cornell@nhs.net., Benson C; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK., Napolitano A; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK., Blackledge M; Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK., Sumhonmun T; Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK., Moskovic E; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK., Kelly-Morland C; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK., Adejolu M; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK., Jones RL; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK; Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK., Messiou C; Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK; Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK. Electronic address: Christina.Messiou@rmh.nhs.uk.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2023 Oct; Vol. 192, pp. 113261. Date of Electronic Publication: 2023 Jul 27.
DOI: 10.1016/j.ejca.2023.113261
Abstrakt: Aim: To evaluate the incidence of pseudoprogression in patients with metastatic or inoperable uterine leiomyosarcoma (LMS) treated with first-line single-agent doxorubicin.
Methods: The Royal Marsden NHS Foundation Trust Sarcoma Unit database was searched to identify all patients with metastatic or inoperable LMS treated with first-line doxorubicin from January 2006 to January 2022. Patients with available computed tomography scans performed at baseline and during doxorubicin therapy were included. Response evaluation criteria in solid tumours v1.1 and Choi criteria were applied. Any increase in the sum of the longest diameter that decreased on the subsequent scan was labelled as pseudoprogression.
Results: The total number of patients evaluated was 52. In total, 19% (n = 10) of patients treated with doxorubicin showed pseudoprogression. However, pseudoprogression at the time of the second scan was not associated with time to doxorubicin failure. Choi criteria identified 30% (n = 3) of pseudoprogressors as responding.
Conclusion: Despite the use of doxorubicin as first-line therapy for soft-tissue sarcomas for over 40 years, pseudoprogression has not been described. This retrospective study shows that pseudoprogression occurs in 19% of patients with metastatic/inoperable uterine LMS treated with first-line doxorubicin. Choi criteria were not consistently able to differentiate pseudoprogression from true progression. It is imperative that oncologists and radiologists are aware of this as symptomatically stable/improving patients may benefit from continued treatment despite initial radiological growth in tumour size.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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