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Accreditation/ Credit Designation

Physicians' Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Lilly. For further information concerning Lilly grant funding, visit www.lillygrantoffice.com.

Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies - PER Pulse™ Recap
PER Pulse™ Recap

Resources

Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies
Earn up to 1.0 AMA PRA Category 1 Credit™
This activity focuses on soft tissue sarcoma (STS), and features a series of short video interviews with leading experts who address a variety of questions commonly faced by practicing community oncologists. The content and interviews are based on presentations given at Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies, a CME-certified, ancillary satellite symposium of the Annual Sarcoma Meeting held in Salt Lake City, Utah.

PER Pulse™ Recap
PER Pulse™ Recaps for Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies® focuses on common clinical questions related to the management of advanced soft tissue sarcoma.



PER Pulse™ Recap PER Pulse™ Recap
Medical Writer: Kim Farina, PhD


1 of 3
PER Pulse™ Recap
Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies

This first of 3 PER Pulse™ Recaps summarizing the online CME publication Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies focuses on clinically relevant data in frontline therapy for unresectable/metastatic soft tissue sarcoma (STS).

Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies was designed to update physicians on key clinical data and highlights in STS presented at a live, CME-certified, ancillary symposium that coincided with the 2015 Connective Tissue Oncology Society Annual Meeting. The activity is accompanied by video interviews with the symposium faculty - George D. Demetri, MD; Robin L. Jones, BSc, MB, MRCP, MD (Res); and William D. Tap, MD—covering contemporary first-line management of advanced STS.

Soft tissue sarcomas are rare and diverse tumors for which clinical trial evidence to guide treatment decisions is lacking. Clinical trial enrollment is the preferred management option for patients with unresectable/metastatic STS. Although the role of chemotherapy has not been clearly delineated in STS, anthracycline- or gemcitabine-based regimens are commonly used as initial therapy for unresectable/metastatic disease. Palliation is a primary goal of systemic therapy for STS and may slow disease progression.

The faculty discussed the importance of data from the phase III GeDDiS trial of frontline doxorubicin versus gemcitabine plus docetaxel for advanced unresectable/metastatic STS (N = 257). Median progression-free survival (PFS) of 23 weeks with doxorubicin (24-week PFS, 46.1%) and 24 weeks (46.0%) with gemcitabine plus docetaxel were reported (hazard ratio [HR], 1.28; 95% CI, 1.0-1.7; P =.07). Gemcitabine plus docetaxel was associated with more toxicity than single-agent doxorubicin.

  • Dr. Jones noted that the results of the GeDDiS trial confirm use of single-agent doxorubicin as standard first-line therapy for unresectable/metastatic STS, including leiomyosarcoma.
  • Dr. Tap commented that the GeDDiS data support use of either regimen. He also mentioned the importance of factoring overall goals of therapy, as well as clinical and disease considerations into treatment selection.
  • Dr. Demetri stated that the results of the GeDDiS trial provide clinicians with high-quality data on which to base treatment decisions. He discussed the importance of considering patient preference during management planning. He recommends reviewing the nature of palliative therapy with patients, as well as toxicity versus efficacy, timing and administration considerations, and follow-up requirements for each treatment option.
     

2 of 3
PER Pulse™ Recap
Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies

This second of 3 PER Pulse™ Recaps summarizing the online CME publication Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies focuses on clinically relevant data in the management of unresectable/metastatic soft tissue sarcoma (STS) beyond progression.

Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies was designed to update physicians on key clinical data and highlights in STS presented at a live, CME-certified, ancillary symposium that coincided with the 2015 Connective Tissue Oncology Society Annual Meeting. The activity is accompanied by video interviews with the symposium faculty - George D. Demetri, MD; Robin L. Jones, BSc, MB, MRCP, MD (Res); and William D. Tap, MD - covering contemporary management of advanced STS.

The faculty discussed the clinical relevance of recently reported data from phase III trials in pretreated, advanced liposarcoma and leiomyosarcoma. In one study, Schöffski et al reported a 2-month improvement in overall survival (OS) with eribulin versus dacarbazine (13.5 mo vs 11.5 mo, respectively; hazard ratio [HR], 0.768; 95% CI, 0.6-1.0; P =.017); however, no difference in progression-free survival (PFS) was evident. Preplanned OS analysis showed greater benefit among patients with liposarcoma versus leiomyosarcoma (HR, 0.511; 95% CI, 0.3-0.8 vs HR, 0.927; 95% CI, 0.7-1.2).

Published results of a study comparing trabectedin versus dacarbazine after 2 or more therapies (including an anthracycline) demonstrated superior median PFS with trabectedin (4.2 mo with trabectedin vs 1.5 mo with dacarbazine; HR, 0.55; 95% CI, 0.4-0.7; P <.001). Median OS was not significantly different at planned interim analysis.

  • Dr. Tap remarked that based on forest plots from subset analyses performed on these study data, he might use eribulin preferentially for liposarcoma and trabectedin for leiomyosarcoma.
  • Dr. Jones agreed that trabectedin is useful for patients with certain subtypes (eg, myxoid round cell liposarcoma) and also for patients with comorbidities that would preclude use of an anthracycline.
  • Dr. Demetri said that at his institution, both eribulin and trabectedin are discussed as options with patients in the context of differences in how they are delivered, study data, and treatment goals.
     

3 of 3
PER Pulse™ Recap
Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies

This third of 3 PER Pulse™ Recaps summarizing the online CME publication Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies focuses on emerging management strategies for unresectable/metastatic soft tissue sarcoma (STS).

Community Practice Connections™: Breakthroughs in Soft Tissue Sarcoma: Perspectives on Emerging Strategies was designed to update physicians on key clinical data and highlights in STS presented at a live, CME-certified, ancillary symposium that coincided with the 2015 Connective Tissue Oncology Society Annual Meeting. The activity is accompanied by video interviews with the symposium faculty - George D. Demetri, MD; Robin L. Jones, BSc, MB, MRCP, MD (Res); and William D. Tap, MD - covering contemporary management of advanced STS.

The faculty discussed investigational therapies for advanced STS that have had promising results in clinical trials.

Olaratumab is a monoclonal antibody that blocks platelet-derived growth factor receptor a signaling. In a randomized phase II study, frontline olaratumab plus doxorubicin yielded a 2.5-month improvement in median progression-free survival (PFS) over doxorubicin alone (median PFS: doxorubicin + olaratumab, 6.6 months vs doxorubicin, 4.1 months; hazard ratio [HR], 0.672; 95% CI, 0.4-1.0; P =.0615). At interim analysis, median overall survival (OS) was prolonged by 10.3 months in the combination arm (median OS: doxorubicin plus olaratumab, 25.0 mo vs doxorubicin alone, 14.7 mo; HR, 0.44; P =.0005).

Evofosfamide (also known as TH-302) is a hypoxia-activated prodrug of a cytoxic alkylating agent. A nonrandomized phase II study of frontline evofosfamide plus doxorubicin for advanced STS demonstrated median PFS of 6.5 months (95% CI, 5.8-7.7), median OS of 21.5 months (95% CI, 16.0-26.2), and response rate of 34%.

  • Dr. Demetri remarked that data from several phase III STS trials are about to be analyzed, and hopefully will be presented in 2016.
  • The faculty agreed that pending OS data from a phase III study of frontline evofosfamide plus doxorubicin versus doxorubicin alone are very important for the sarcoma community, and at the top of their watch lists.
    • Dr. Demetri speculated that improved OS and response rate with evofosfamide in the phase III trial could establish a new standard of care for untreated metastatic STS.
  • Dr. Tap also discussed the importance of the ongoing phase III study of olaratumab plus doxorubicin versus doxorubicin alone.
  • Other agents of interest to the faculty include aldoxorubicin; novel therapies such as inhibitors of EZH2, MDM2, or CDK4; and immunotherapeutics (eg, nivolumab).
     


Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.

Supported by an educational grant from Lilly. For further information concerning Lilly grant funding, visit www.lillygrantoffice.com.




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