Real-World Effectiveness of Pazopanib on Advanced Synovial Sarcoma: Meta-Analysis
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: Synovial sarcoma (SS) is a histological subtype of soft tissue sarcoma (STS) with a high rate of metastasis and/or recurrence. Pazopanib is the only targeted therapy approved by FDA to treat advanced STS. To estimate the real-world effectiveness of pazopanib on advanced SS through a systematic literature review and meta-analysis. Methods: Medline was searched from January 1, 2012 to December 31, 2020, with the keywords of pazopanib AND soft AND tissue AND sarcoma. The Preferred Reporting Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used. Observational studies in adults with advanced SS were included. Studies that did not report the histology-specific outcomes were excluded. Effectiveness outcomes included response rate (RR) (complete response [CR] and partial response [PR]) and clinical benefit (CR and PR plus stable disease [SD]). Considering the additional uncertainty associated with the effects of treatment, a random- effects model was performed using R version 4.1.1. Heterogeneity was assessed using the inconsistency index (I2). Sensitivity analysis was conducted with a broader definition of SD. Results: Of 263 potentially relevant studies identified, seven observational studies were included in the meta- analysis. A total of 94 adult patients with advanced SS were included and the median sample size was 14. Three studies were conducted in South Korea and the remaining four studies were conducted in various countries. Five studies reported median progression-free survival in addition to tumor responses. The estimated RR of pazopanib was 16.4% (95% confidence interval [CI]: 0.05 to 0.28; I2=60%) and 62.9% of patients showed clinical benefit (95% CI: 0.44 to 0.82; I2=74%). Conclusion: Pazopanib controlled advanced SS as effectively as first-line chemotherapy. With increasing emphasis being given to understanding the histology-specific treatment effect, the present study adds important information to the existing literature on the treatment of advanced SS.
Abstract
Objectives: Synovial sarcoma (SS) is a histological subtype of soft tissue sarcoma (STS) with a high rate of metastasis and/or recurrence. Pazopanib is the only targeted therapy approved by FDA to treat advanced STS. To estimate the real-world effectiveness of pazopanib on advanced SS through a systematic literature review and meta-analysis. Methods: Medline was searched from January 1, 2012 to December 31, 2020, with the keywords of pazopanib AND soft AND tissue AND sarcoma. The Preferred Reporting Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used. Observational studies in adults with advanced SS were included. Studies that did not report the histology-specific outcomes were excluded. Effectiveness outcomes included response rate (RR) (complete response [CR] and partial response [PR]) and clinical benefit (CR and PR plus stable disease [SD]). Considering the additional uncertainty associated with the effects of treatment, a random- effects model was performed using R version 4.1.1. Heterogeneity was assessed using the inconsistency index (I2). Sensitivity analysis was conducted with a broader definition of SD. Results: Of 263 potentially relevant studies identified, seven observational studies were included in the meta- analysis. A total of 94 adult patients with advanced SS were included and the median sample size was 14. Three studies were conducted in South Korea and the remaining four studies were conducted in various countries. Five studies reported median progression-free survival in addition to tumor responses. The estimated RR of pazopanib was 16.4% (95% confidence interval [CI]: 0.05 to 0.28; I2=60%) and 62.9% of patients showed clinical benefit (95% CI: 0.44 to 0.82; I2=74%). Conclusion: Pazopanib controlled advanced SS as effectively as first-line chemotherapy. With increasing emphasis being given to understanding the histology-specific treatment effect, the present study adds important information to the existing literature on the treatment of advanced SS.
참고문헌 (16)
- Clark MA, "Soft-tissue sarcomas in adults", N Engl J Med, 353, pp.701~711 (2005)
- Eilber FC, "Diagnosis and management of synovial sarcoma", J Surg Oncol, 97, pp.314~320 (2008)
- "Plymouth Meeting" (2021)[URL]
- Vlenterie M, "Outcome of chemotherapy in advanced synovial sarcoma patients : review of 15 clinical trials from the European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group; setting a new landmark for studies in this entity", Eur J Cancer, 58, pp.62~72 (2016)
- van der Graaf WT, "Pazopanib for metastatic soft-tissue sarcoma(PALETTE) : a randomised, double-blind, placebo-controlled phase 3 trial", Lancet, 379, pp.1879~1886 (2012)
- Yoo KH, "Efficacy of pazopanib monotherapy in patients who had been heavily pretreated for metastatic soft tissue sarcoma : a retrospective case series", BMC Cancer, 15, pp.154~ (2015)
- Nakamura T, "The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma : a Japanese Musculoskeletal Oncology Group(JMOG)study", Cancer, 122, pp.1408~1416 (2016)
- Oh CR, "Realworld outcomes of pazopanib treatment in Korean patients with advanced soft tissue sarcoma : a multicenter retrospective cohort Study", Target Oncol, 15, pp.485~493 (2020)
- Kim JH, "Differences in the efficacies of pazopanib and gemcitabine", docetaxel as second-line treatments for metastatic soft tissue sarcoma, 2019, pp.96, 59~69
- Gelderblom H, "Treatment patterns and clinical outcomes with pazopanib in patients with advanced soft tissue sarcomas in a compassionate use setting : results of the SPIRE study", Acta Oncol, 56, pp.1769~1775 (2017)
- Seto T, "Real-world experiences with pazopanib in patients with advanced soft tissue and bone sarcoma in Northern California", Med Sci(Basel), 7, pp.48~ (2019)
- Koca S, "Pazopanib for metastatic soft-tissue sarcoma: a multicenter retrospective study", J Oncol Pharm Pract, 27, pp.541~546 (2021)
- Moreau-Bachelard C, "Patterns of care and outcomes of 417 patients with METAstatic SYNovial sarcoma (METASYN): real-life data from the French Sarcoma Group (FSG)", ESMO Open, 7, pp.100402~ (2022)
- Nakano K, "Differences in the responses to pazopanib and the prognoses of soft tissue sarcomas by their histological eligibility for the PALETTE study", Jpn J Clin Oncol, 45, pp.449~455 (2015)
- Tian Z, "High cumulative doxorubicin dose for advanced soft tissue sarcoma", BMC Cancer, 20, pp.1139~ (2020)
- Schmoll HJ, "Efficacy of pazopanib with or without gemcitabine in patients with anthracycline-and", or ifosfamide-refractory soft tissue sarcoma : final results of the PAPAGEMO phase 2 randomized clinical trial, 2021, pp.7, 255~262