Soft Tissue Sarcoma: Nivolumab With Trabectedin Is Safe and Clinically Active
Trabectedin, an alkylating agent, removes tumor growth–promoting M2 macrophages, leading to more effective natural killer T cell activity.
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Trabectedin and nivolumab are a promising combination for patients with advanced soft tissue sarcoma, according to an oral presentation at the Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting.1
Trabectedin, an alkylating agent, removes tumor growth–promoting M2 macrophages, leading to more effective natural killer T cell activity. For this retrospective study, researchers evaluated whether intravenous nivolumab, a PD-1 inhibitor, is safe and effective when given with trabectedin.
Twenty patients included in the study had metastatic disease. Of those, 8 had undifferentiated pleomorphic liposarcoma, 4 had leiomyosarcoma, 3 had synovial sarcoma, 4 had myxoid liposarcoma, and 1 had chondrosarcoma; the median number of previous chemotherapy lines was 4.
Of the 13 patients followed for at least 6 months, 3 had a partial response, 7 had stable disease, and 3 had progressive disease, representing a disease control rate of 76.9%. Median progression-free survival was 7.8 months; median overall survival was 8.4 months.
The presenter noted that the median progression-free survival was 3.6 months longer than that observed with trabectedin alone.
Grade 3 adverse events included anemia, fatigue, decreased platelet count, decreased granulocyte count, and increased creatine kinase, though none of these were observed in more than 2 patients.
The authors concluded that “the data suggest that paired administration of trabectedin and nivolumab is safe, and that this chemo-/immuno-therapy approach has synergistic activity.”
A study is being planned in which trabectedin will be given in conjunction with nivolumab and ipilimumab, a CTLA-4 inhibitor.
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- Chawla S, Sankhala K, Nathan S, et al. Cancer immunotherapy using trabectedin and nivolumab in advanced soft tissue sarcoma: a retrospective analysis. Oral presentation at: Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting. November 8-11, 2017; Maui, Hawaii.