Este protocolo es aplicable a pacientes con mixofibrosarcoma localmente avanzado irresecable o metastásico — una etapa asociada con un pronóstico muy desfavorable — que ya han recibido terapia sistémica de primera línea basada en antraciclinas sin lograr una respuesta adecuada.
El tratamiento de primera línea con antraciclina con o sin ifosfamida no alcanzó el objetivo requerido de respuesta tumoral parcial en imagen.
Respuesta radiológica insuficiente → escalar a siguiente líneaDOI: 10.3390/diagnostics13193022
The development of unresectable locally advanced or metastatic MFS is assocaited with a very poor prognosis.
Gemcitabine can be used as a monotherapy or in combination with docetaxel or dacarbazine in pretreated STS patients.
Although the exact role of gemcitabine remains unclear, gemcitabine-based therapy can be an effective option for metastatic MFS patients.
Trabectedin can be administered effectively and safely to patients with advanced STS at second- or later-line setting.
Japan is the only country where eribulin is approved for all types of STS, including non-L-sarcomas such as MFS and UPS.
Pazopanib is an oral multitargeted tyrosine kinase inhibitor (TKI) with anti-angiogenic and anti-tumorigenic properties and it has been approved in multiple countries as a second- or later-line treatment for patients with advanced non-adipocytic STS.
In a single-arm open-label multicenter phase 2 trial (SARC028), pembrolizumab (anti-PD-1 antibody) provided an objective response rate (ORR) of 18% in the STS cohort.
In a randomized open-label non-comparative multicenter phase 2 trial (Alliance A091401), 85 patients with metastatic sarcoma received either nivolumab alone or nivolumab in combination with ipilimumab (anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) antibody).
A radiological PR or complete response (CR) was observed in four (57%) of the seven patients.
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