Leiomyosarcoma Clinical Trial
Official title:
A Phase II Randomized - Non Comparative - Study on the Activity of Trabectedin or Gemcitabine + Docetaxel in Metastatic or Locally Relapsed Uterine Leiomyosarcoma Pretreated With Conventional Chemotherapy
The management of patients with uterine leiomyosarcomas poses many difficulties. Despite 60%
of women present with disease limited to the uterus, cure rates range from 20 to 60%.
Patients with metastatic disease at diagnosis or who recur after initial treatment have a
dismal prognosis and, except for a subset of selected patients with completely resectable
disease, the median survival is less than one year. Treatment options for
recurrent/metastatic uterine leiomyosarcoma are limited. The most active drugs are
doxorubicin ± ifosfamide and gemcitabine + docetaxel (GD) with response rate of 25-55% and
27-53%, respectively. Both these regimens have been increasingly used in the last years also
in the adjuvant setting. For relapsed patients other drugs have been tested as single agent
but negligible activity was observed.
Trabectedin (Yondelis® -T) is a marine-derived cytotoxic approved by EMEA. It is indicated
for the treatment of patients with advanced soft tissue sarcoma, after failure of
anthracyclines and ifosfamide or who are unsuitable to receive these agents. Among STS,
activity has been mainly detected in synovial sarcoma, liposarcoma and leiomyosarcoma.
Although the response rate did not exceed 10%, T was demonstrated to provide disease control,
with progression arrest rates exceeding 50% and progression-free survival rates exceeding 20%
at 6 months. So far no phase II studies tested the activity of T in uterine leiomyosarcoma
specifically. This study is aimed at evaluating the activity of T (arm A) in advanced uterine
leiomyosarcomas, having GD (arm B) as an internal control In parallel translational studies
will be performed to identify factors predictive of the activity of T in this specific
histotype.
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