Este protocolo aplica-se a pacientes com mixofibrossarcoma localmente avançado irressecável ou metastático — um estágio associado a um prognóstico muito desfavorável — que já receberam terapia sistêmica de primeira linha baseada em antraciclina sem obter resposta adequada.
O tratamento de primeira linha com antraciclina com ou sem ifosfamida não atingiu o objetivo exigido de resposta tumoral parcial ao exame de imagem.
Resposta radiológica insuficiente → escalonar para a próxima linhaDOI: 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.
View source ↗