Pseudoprogression in patients with uterine leiomyosarcoma treated with first-line single-agent doxorubicin.
Date
2023-10-01ICR Author
Author
Howroyd, L-R
Cornell, I
Benson, C
Napolitano, A
Blackledge, M
Sumhonmun, T
Moskovic, E
Kelly-Morland, C
Adejolu, M
Jones, RL
Messiou, C
Type
Journal Article
Metadata
Show full item recordAbstract
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.
Collections
Subject
Disease progression
Doxorubicin
Leiomyosarcomas
Pseudoprogression
Radiological response
Sarcomas
Systemic therapy
Uterine neoplasms
Humans
Leiomyosarcoma
Retrospective Studies
Sarcoma
Doxorubicin
Soft Tissue Neoplasms
Neoplasms, Second Primary
Language
eng
Date accepted
2023-07-24
License start date
2023-10-01
Citation
European Journal of Cancer, 2023, 192 pp. 113261 -
Publisher
ELSEVIER SCI LTD