Soft Tissue Sarcoma Update, Issue 1, 2017 (Video Program)Improvement in overall survival with eribulin versus dacarbazine for patients with previously treated advanced liposarcoma or leiomyosarcoma
1:50 minutes.
TRANSCRIPTION:
DR VAN TINE: This is a wonderful discussion that I like to have about how histology matters. And so when you get into the trabectedin trial, you find that there is subset analysis that shows activity of trabectedin amongst many, many, many different histologies. Especially when you get into the extended data. The interesting thing about the trabectedin trial is that it was positive for progression-free survival and not overall survival. Eribulin is a lesson that histology really does matter, because there was a positive overall survival in the eribulin Phase III trial but not a progression-free survival. And it turns out that the positivity in the eribulin trial is driven almost exclusively by the liposarcoma patients in the trial, but they only represent a third of the trial. And so what you find is, this is probably a drug that’s best used only for liposarcomas that are high grade, as the activity in leiomyosarcoma is really no better than or potentially even not as good as dacarbazine. And so this is why one of the things that I go back to is one of the first things we talked about, is the parallel words of sarcoma is carcinoma. And leiomyosarcoma and the liposarcoma are completely different diseases. And one subset of liposarcomas are driven by MDM2 amplifications, where a lot of leiomyosarcomas have a p53 mutation. And so there’s different kinds of breast cancer and how they should be approached, but we put them all into trials together. And so as you get into the data, what you find is that eribulin is a good liposarcoma drug, and you should probably be focused there. |