Pathologic complete response (pCR) is associated with improved long-term outcomes in patients with soft tissue sarcoma (STS), according to research published in JAMA Oncology.

Patients who achieved a pCR after neoadjuvant therapy and surgery had improvements in overall survival (OS), disease-free survival (DFS), and distant DFS, researchers found.

This study included data from 143 STS patients from 2 nonrandomized trials. Sixty-four patients from the RTOG 9514 trial (ClinicalTrials.gov Identifier: NCT00002791) who received neoadjuvant chemoradiotherapy (CRT) and 79 patients from the RTOG 0630 trial (ClinicalTrials.gov Identifier: NCT00589121) who received neoadjuvant radiotherapy (RT) were included. 

Continue Reading

The percentage of patients with a pCR was 20.7% overall, 23.0% in patients treated with CRT, and 18.9% in those treated with RT. 

Among patients who achieved a pCR, the 5-year OS rate was 100%. Among patients who did not achieve a pCR, the 5-year OS rate was 76.5% in the CRT cohort and 56.4% in the RT cohort. 

In the CRT cohort, the 5-year DFS rate was 88.9% in patients who achieved a pCR and 62.7% in those who did not. In the RT cohort, the 5-year DFS rate was 90.9% and 40.0%, respectively. 

In a multivariable analysis of 112 evaluable patients, pCR was significantly associated with:

  • Superior OS (hazard ratio [HR] could not be estimated due to no events; P =.01) 
  • Superior DFS (HR, 4.91; 95% CI, 1.51-15.93; P =.008). 
  • Superior distant DFS (HR, 4.33; 95% CI, 1.32-14.14; P =.02) 
  • A lower risk of distant metastasis (HR, 4.09; 95% CI, 1.25-13.36; P =.02).

“This ancillary analysis of 2 nonrandomized clinical trials found that pCR was associated with improved survival in patients with STS and should be considered as a prognostic factor of clinical outcomes for future studies,” the researchers concluded.

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Wang D, Harris J, Kraybill WG, et al. Pathologic complete response and clinical outcomes in patients with localized soft tissue sarcoma treated with neoadjuvant chemoradiotherapy or radiotherapy: The NRG/RTOG 9514 and 0630 nonrandomized clinical trials. JAMA Oncol. Published online March 30, 2023. doi:10.1001/jamaoncol.2023.0042

Topics:

Sarcoma