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Frezza, A.M.; Ravi, V.; Vullo, S. lo; Vincenzi, B.; Tolomeo, F.; Chen, T.W.W.; ... ; Stacchiotti, S. (2021)

Systemic therapies in advanced epithelioid haemangioendothelioma: a retrospective international case series from the World Sarcoma Network and a review of literature

Article / Letter to editor
Background This observational, retrospective effort across Europe, US, Australia, and Asia aimed to assess the activity of systemic therapies in EHE, an ultra-rare sarcoma, marked by WWTR1-CAMTA1 or YAP1-TFE3 fusions.Methods Twenty sarcoma reference centres contributed data. Patients with advanced EHE diagnosed from 2000 onwards and treated with systemic therapies, were selected. Local pathologic review and molecular confirmation were required. Radiological response was retrospectively assessed by local investigators according to RECIST. Progression free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier method.Results Overall, 73 patients were included; 21 had more than one treatment. Thirty-three patients received anthracyclines regimens, achieving 1 (3%) partial response (PR), 25 (76%) stable disease (SD), 7 (21%) progressive disease (PD). The median (m-) PFS and m-OS were 5.5 and 14.3 months respectively. Eleven patients received paclitaxel, achieving 1 (9%)...Show moreBackground This observational, retrospective effort across Europe, US, Australia, and Asia aimed to assess the activity of systemic therapies in EHE, an ultra-rare sarcoma, marked by WWTR1-CAMTA1 or YAP1-TFE3 fusions.Methods Twenty sarcoma reference centres contributed data. Patients with advanced EHE diagnosed from 2000 onwards and treated with systemic therapies, were selected. Local pathologic review and molecular confirmation were required. Radiological response was retrospectively assessed by local investigators according to RECIST. Progression free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier method.Results Overall, 73 patients were included; 21 had more than one treatment. Thirty-three patients received anthracyclines regimens, achieving 1 (3%) partial response (PR), 25 (76%) stable disease (SD), 7 (21%) progressive disease (PD). The median (m-) PFS and m-OS were 5.5 and 14.3 months respectively. Eleven patients received paclitaxel, achieving 1 (9%) PR, 6 (55%) SD, 4 (36%) PD. The m-PFS and m-OS were 2.9 and 18.6 months, respectively. Twelve patients received pazopanib, achieving 3 (25%) SD, 9 (75%) PD. The m-PFS and m-OS were.2.9 and 8.5 months, respectively. Fifteen patients received INF-alpha 2b, achieving 1 (7%) PR, 11 (73%) SD, 3 (20%) PD. The m-PFS and m-OS were 8.9 months and 64.3, respectively. Among 27 patients treated with other regimens, 1 PR (ifosfamide) and 9 SD (5 gemcitabine +docetaxel, 2 oral cyclophosphamide, 2 others) were reported.Conclusion Systemic therapies available for advanced sarcomas have limited activity in EHE. The identification of new active compounds, especially for rapidly progressive cases, is acutely needed.Show less
anthracycline
chemotherapy
epithelioid haemangioendothelioma
interferon
paclitaxel
pazopanib
All authors
Frezza, A.M.; Ravi, V.; Vullo, S. lo; Vincenzi, B.; Tolomeo, F.; Chen, T.W.W.; Teterycz, P.; Baldi, G.G.; Italiano, A.; Penel, N.; Brunello, A.; Duffaud, F.; Hindi, N.; Iwata, S.; Smrke, A.; Fedenko, A.; Gelderblom, H.; Graaf, W. van der; Vozy, A.; Connolly, E.; Grassi, M.; Benjamin, R.S.; Broto, J.M.; Grignani, G.; Jones, R.L.; Kawai, A.; Tysarowski, A.; Mariani, L.; Casali, P.G.; Stacchiotti, S.
Date
2021-03-13
Journal
Cancer Medicine
Volume
10
Issue
8
Pages
2645 - 2659
DOI
doi:10.1002/cam4.3807
Link
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.3807