Martínez-Trufero Javier, De Sande-González Luis Miguel, Luna Pablo, Martin-Broto Javier, Álvarez Rosa, Marquina Gloria, Diaz-Beveridge Roberto, Poveda Andrés, Cano Juana María, Cruz-Jurado Josefina, López Pousa Antonio, Vaz Salgado María Angeles, Valverde-Morales Claudia M, Sevilla Isabel, Martínez-García Jerónimo, Rubio-Casadevall Jordi, De Juan Ana, Carrasco Juan Antonio, Moura David S, Gurruchaga-Sotes Ibon, Gutiérrez Antonio
Javier Martinez-Trufero, Medical Oncology Department, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain.
Medical Oncology Department, Complejo Asistencial Universitario de Leon, 24008 Leon, Spain.
Cancers (Basel). 2021 Feb 14;13(4):792. doi: 10.3390/cancers13040792.
The aim of this study was to identify an easily reliable prognostic score that selects the subset of advanced soft tissue sarcoma (ASTS) patients with a higher benefit with trabectedin in terms of time to progression and overall survival. A retrospective series of 357 patients with ASTS treated with trabectedin as second- or further-line in 19 centers across Spain was analyzed. First, it was confirmed that patients with high growth modulation index (GMI > 1.33) were associated with the better clinical outcome. Univariate and multivariate analyses were performed to identify factors associated with a GMI > 1.33. Thus, GEISTRA score was based on metastasis free-interval (MFI ≤ 9.7 months), Karnofsky < 80%, Non L-sarcomas and better response in the previous systemic line. The median GMI was 0.82 (0-69), with 198 patients (55%) with a GMI < 1, 41 (11.5%) with a GMI 1-1.33 and 118 (33.1%) with a GMI > 1.33. The lowest GEISTRA score showed a median of time-to-progression (TTP) and overall survival (OS) of 5.7 and 19.5 months, respectively, whereas it was 1.8 and 3.1 months for TTP and OS, respectively, for the GEISTRA 4 score. This prognostic tool can contribute to better selecting candidates for trabectedin treatment in ASTS.
本研究的目的是确定一种易于使用且可靠的预后评分系统，以筛选出在接受曲贝替定治疗后，在疾病进展时间和总生存期方面获益更大的晚期软组织肉瘤（ASTS）患者亚组。对西班牙19个中心接受曲贝替定二线或后续治疗的357例ASTS患者进行了回顾性分析。首先，证实生长调节指数高（GMI>1.33）的患者临床结局更好。进行单因素和多因素分析以确定与GMI>1.33相关的因素。因此，GEISTRA评分基于无转移间期（MFI≤9.7个月）、卡诺夫斯基评分<80%、非L型肉瘤以及先前全身治疗线中的更好反应。GMI的中位数为0.82（0-69），其中198例患者（55%）GMI<1，41例（11.5%）GMI为1-1.33，118例（33.1%）GMI>1.33。GEISTRA评分最低的患者疾病进展时间（TTP）和总生存期（OS）中位数分别为5.7个月和19.5个月，而GEISTRA 4评分的患者TTP和OS中位数分别为1.8个月和3.1个月。这种预后工具有助于更好地筛选ASTS患者中适合曲贝替定治疗的候选者。
