TY - JOUR
T1 - Hormonal manipulation with toremifene in sporadic desmoid-type fibromatosis
AU - Fiore, Marco
AU - Colombo, Chiara
AU - Radaelli, Stefano
AU - Callegaro, Dario
AU - Palassini, Elena
AU - Barisella, Marta
AU - Morosi, Carlo
AU - Baldi, Giacomo G.
AU - Stacchiotti, Silvia
AU - Casali, Paolo G.
AU - Gronchi, Alessandro
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Introduction Many patients affected by desmoid-type fibromatosis (DF) are treated with a course of hormonal therapy as front line. So far, tamoxifene has been the preferred choice. Toremifene is an anti-oestrogen agent, but possible further mechanisms of action in desmoids are related to its role in regulation of transforming growth factor-beta and β-catenin pathways. Material and methods We retrospectively reviewed all patients treated with toremifene between 2005 and 2012 at a reference institution. Indication to toremifene was radiologically progressive disease and/or symptomatic deterioration. Progression-free survival (PFS), clinical benefit (CB) and safety profile were analysed. Results Forty-four patients were treated with toremifene 180 mg daily, 20 for radiological progression, 16 for pain and 8 for both. In 28 patients, toremifene was offered as front-line therapy, while in 11 after tamoxifen failure. PFS was 89.6% at 2 years. According to Response Evaluation Criteria in Solid Tumours, partial response, stable disease and disease progression were observed in 25%, 65% and 10% of the patients, respectively. Symptomatic relief was obtained in 75% of patients. Median time to response was 4 months. Overall CB was 86%. Adverse events G≥2 according to National Cancer Institute Common Toxicity Criteria were recorded in ten patients. Discussion Present series provides evidence to make toremifene an option in patients with DF, even after failure on different hormonal agents. A prospective trial is ongoing to confirm these results.
AB - Introduction Many patients affected by desmoid-type fibromatosis (DF) are treated with a course of hormonal therapy as front line. So far, tamoxifene has been the preferred choice. Toremifene is an anti-oestrogen agent, but possible further mechanisms of action in desmoids are related to its role in regulation of transforming growth factor-beta and β-catenin pathways. Material and methods We retrospectively reviewed all patients treated with toremifene between 2005 and 2012 at a reference institution. Indication to toremifene was radiologically progressive disease and/or symptomatic deterioration. Progression-free survival (PFS), clinical benefit (CB) and safety profile were analysed. Results Forty-four patients were treated with toremifene 180 mg daily, 20 for radiological progression, 16 for pain and 8 for both. In 28 patients, toremifene was offered as front-line therapy, while in 11 after tamoxifen failure. PFS was 89.6% at 2 years. According to Response Evaluation Criteria in Solid Tumours, partial response, stable disease and disease progression were observed in 25%, 65% and 10% of the patients, respectively. Symptomatic relief was obtained in 75% of patients. Median time to response was 4 months. Overall CB was 86%. Adverse events G≥2 according to National Cancer Institute Common Toxicity Criteria were recorded in ten patients. Discussion Present series provides evidence to make toremifene an option in patients with DF, even after failure on different hormonal agents. A prospective trial is ongoing to confirm these results.
KW - Aggressive fibromatosis
KW - Desmoid-type fibromatosis
KW - Hormonal therapy
KW - Soft tissue sarcoma
KW - Toremifene
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U2 - 10.1016/j.ejca.2015.08.026
DO - 10.1016/j.ejca.2015.08.026
M3 - Article
C2 - 26602014
AN - SCOPUS:84959576037
VL - 51
SP - 2800
EP - 2807
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 18
ER -