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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1437732
This article is part of the Research Topic Multimodality Therapy for Older Cancer Patients View all 9 articles

Trabectedin Emerges as the may be a Valuable Leading Choice Treatment Option for Elderly Patients with Metastatic Soft Tissue Sarcomas

Provisionally accepted
Gianmaria Miolo Gianmaria Miolo 1Angela Buonadonna Angela Buonadonna 1Davide Lombardi Davide Lombardi 1Simona Scalone Simona Scalone 1Andrea Lauretta Andrea Lauretta 2Lara Della Puppa Lara Della Puppa 3Giuseppe Corona Giuseppe Corona 4*
  • 1 Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
  • 2 Unit of General Oncologic Surgery, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
  • 3 Oncogenetics and Functional Oncogenomics Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy, Aviano Oncology Reference Center (IRCCS), Aviano, Italy
  • 4 Aviano Oncology Reference Center (IRCCS), Aviano, Italy

The final, formatted version of the article will be published soon.

    Background: In the landscape of metastatic soft tissue sarcomas (mSTS) treatment, anthracyclines have shown efficacy; however, their associated toxicity imposes significant limitations, especially in frail elderly mSTS patients who are highly susceptible to severe adverse effects. In this context, trabectedin, due to its distinct pharmacological profile and safety profile may represent an interesting alternative being demonstrated active in treating mSTS. These features hold particular significance for elderly and unfit mSTS patients, where the balancing treatment benefits with potential adverse effects represents the pivotal objective.The investigation was focused on specific group of 11 elderly mSTS patients aged ≥70, all undergoing first-line treatment with trabectedin and it was supported by comprehensive pharmacokinetic and pharmacodynamic studies. Among these patients, 9 out of 11 started the treatment at the dose of 1.5 mg/m2.The primary objective of this investigation is to highlight trabectedin as a valuable first-line treatment option for elderly and unfit mSTS patients. Additionally, this investigation seeks to explore whether higher administered doses of trabectedin can enhance clinical outcomes while maintaining the same toxicity profiles. The median Progression-Free Survival (PFS) was 77 days (95% CI, 53-89), the median overall survival (OS) was 397 days (95% CI, 66-2102) while the overall toxicity of grade 3-4 severity amounted to 43%.These findings provide new insights into the clinical outcomes and toxicity associated with trabectedin in elderly patient population, enhancing our understanding of better treatment approaches for specific population of mSTS patients.

    Keywords: Cancer, Trabectedin, Elderly, Sarcoma, First-line treatment, pharmacokinetics

    Received: 24 May 2024; Accepted: 08 Jul 2024.

    Copyright: © 2024 Miolo, Buonadonna, Lombardi, Scalone, Lauretta, Della Puppa and Corona. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Giuseppe Corona, Aviano Oncology Reference Center (IRCCS), Aviano, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.