Trabectedin versus dacarbazine for metastatic liposarcoma or leiomyosarcoma after anthracycline failure
Trabectedin reduced the risk of progression by 45 percent compared with dacarbazine in previously treated liposarcoma and leiomyosarcoma, leading to its approval in the United States, though survival was not improved.
Overview
Phase 3 trial of 518 patients with advanced liposarcoma or leiomyosarcoma after an anthracycline and at least one other regimen randomised 2:1 to trabectedin or dacarbazine.
Median progression-free survival was 4.2 versus 1.5 months (hazard ratio 0.55) with benefit in both histologies and particularly in myxoid liposarcoma; median overall survival was 12.4 versus 12.9 months (not significant). Transaminase elevation and myelosuppression were the main toxicities.
- Median progression-free survival 4.2 vs 1.5 months; hazard ratio 0.55.
- No overall survival difference (12.4 vs 12.9 months).
Trabectedin is a standard later-line option for liposarcoma and leiomyosarcoma and is especially active in myxoid liposarcoma.
- Open-label; dacarbazine control performed poorly on progression-free survival.
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