TY - JOUR
T1 - Haematopoietic stem cell transplantation in adult soft-tissue sarcoma: an analysis from the European Society for Blood and Marrow Transplantation.
AU - Heilig, Christoph E.
AU - Badoglio, Manuela
AU - Labopin, Myriam
AU - Fröhling, Stefan
AU - Secondino, Simona
AU - Heinz, Jürgen
AU - Nicolas-Virelizier, Emmanuelle
AU - Blaise, Didier
AU - Korenbaum, Clément
AU - Santoro, Armando
AU - Verbeek, Mareike
AU - Krüger, William
AU - Siena, Salvatore
AU - Passweg, Jakob R.
AU - Di Nicola, Massimo
AU - Rifón, Jose
AU - Dreger, Peter
AU - Koehl, Ulrike
AU - Chabannon, Christian
AU - Pedrazzoli, Paolo
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND: The role of high-dose chemotherapy with autologous stem cell transplantation (ASCT) in the treatment of soft-tissue sarcoma (STS) remains an unsettled issue. Prospective clinical trials failed to prove a benefit of the procedure but were limited by small and heterogeneous patient cohorts. Thus, it is unknown if ASCT may be a valuable treatment option in specific patient subgroups. METHODS: The purpose of this study was to investigate the value of ASCT according to histological subtype in STS patients who were registered in the European Society for Blood and Marrow Transplantation database between 1996 and 2016. RESULTS: Median progression-free (PFS) and overall survival (OS) in the entire cohort of 338 patients were 8.3 and 19.8 months, respectively, and PFS and OS at 5 years were 135 respectively. Analysis of outcomes in different subgroups showed that younger age, better remission status before transplantation and melphalan-based preparative regimen were predictive of benefit from ASCT, whereas histology and grading had no statistically significant impact. CONCLUSIONS: Outcomes after ASCT compared favorably to those of recent trials on conventional chemotherapies and targeted therapies in STS, including histology-tailored approaches. ASCT, thus, should be reinvestigated in clinical trials focusing on defined patient subgroups.
AB - BACKGROUND: The role of high-dose chemotherapy with autologous stem cell transplantation (ASCT) in the treatment of soft-tissue sarcoma (STS) remains an unsettled issue. Prospective clinical trials failed to prove a benefit of the procedure but were limited by small and heterogeneous patient cohorts. Thus, it is unknown if ASCT may be a valuable treatment option in specific patient subgroups. METHODS: The purpose of this study was to investigate the value of ASCT according to histological subtype in STS patients who were registered in the European Society for Blood and Marrow Transplantation database between 1996 and 2016. RESULTS: Median progression-free (PFS) and overall survival (OS) in the entire cohort of 338 patients were 8.3 and 19.8 months, respectively, and PFS and OS at 5 years were 135 respectively. Analysis of outcomes in different subgroups showed that younger age, better remission status before transplantation and melphalan-based preparative regimen were predictive of benefit from ASCT, whereas histology and grading had no statistically significant impact. CONCLUSIONS: Outcomes after ASCT compared favorably to those of recent trials on conventional chemotherapies and targeted therapies in STS, including histology-tailored approaches. ASCT, thus, should be reinvestigated in clinical trials focusing on defined patient subgroups.
KW - high-dose chemotherapy
KW - soft-tissue sarcoma
KW - stem cell transplantation
U2 - 10.1136/esmoopen-2020-000860
DO - 10.1136/esmoopen-2020-000860
M3 - Article
VL - 5
SP - e000860
JO - ESMO Open
JF - ESMO Open
SN - 2059-7029
IS - 5
ER -