Pegylated liposomal doxorubicin in advanced, anthracycline pre-treated liposarcoma patients: Report of a single reference center experience.

Abstract

e23543 Background: Liposarcomas (LPS) encompass a heterogeneous group of soft-tissue sarcomas (SD), including well differentiated/dedifferentiated liposarcoma (WD/DDLPS), myxoid liposarcoma (MLPS), and pleomorphic liposarcoma. These subtypes show variable sensitivity to anthracyclines (AC), commonly used in advanced or metastatic settings. Pegylated liposomal doxorubicin (PLD) is frequently administered in later lines of treatment, usually when no other active drugs are available, even in first-line (1L) AC pre-treated patients (pts). PLD effectiveness in extending progression-free survival (PFS) across anthracycline-pre-treated LPS subtypes is not well documented. Methods: We retrospectively collected 27 consecutive pts (8 males, 19 females) with advanced LPS and treated with PLD at our institution from September 2004. Among them, 18 pts previously received AC either for localized or advanced disease and were included in our analysis. Descriptive statistics analyses were made. PFS was defined as time from the first cycle of PLD to progression (PD) or death and was calculated separately across LPS subtypes. Results: 9 out of 18 pts were diagnosed with WD/DDLPS, 6 had MLPS and 3 had PLPS. Median cumulative dose of previously administered AC was 240 mg/sqm (IQR 205-350). 7 pts received AC in advanced disease setting: 4 pts had stable disease (SD) as best response (BR), while one gained a partial response (PR) and 2 had progressive disease (PD) as BR. Only 1 patient received PLD as 2L therapy, while 8 received PLD in 3L , 5 in 4L and the remaining 4 pts in further lines. PLD was administered at a starting dose of 40 mg/sqm as per clinical practice. A median of 5 (IQR 3-11) PLD cycles were administered in our cohort: 2 PR were registered (1 in DDLPS and 1 in MLPS patient), while 11 pts gained SD as best response and 5 pts had PD at the first evaluation. The two AC primary resistant pts had SD and PD as BR. Median PFS (mPFS) was 5 months (95% CI 3.88 – N.R) in WD/DDLPS pts, 9 months ( 95% CI 4.7 – N.R) in WDLPS pts, 7.6 months (95% CI 6 – N.R) in MLPS pts and 8 months (95% CI 1 – N.R) in PLPS pts. 13 out of 16 progressing to PLD received at least another line of treatment. No severe (G3/G4) adverse events were registered. Conclusions: PLD showed some activity in a retrospective cohort of advanced, anthracycline pre-treated LPS patients across all LPS subtypes. It may represent a therapeutic option for patients with few alternatives.