Hyperthermia Plus Chemotherapy Improves Survival in Soft Tissue Sarcoma

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The study was halted after the experimental arm showed significantly improved relapse-free and overall survival rates compared with the control.
The study was halted after the experimental arm showed significantly improved relapse-free and overall survival rates compared with the control.

Regional hyperthermia (RHT) plus neoadjuvant chemotherapy improves survival among patients with localized high-risk soft tissue sarcoma, according to a study published in JAMA Oncology.1

Previous studies demonstrated that hyperthermia with chemotherapy and ionizing radiation may have a synergistic relationship.

For the open-label phase 3 EORTC 62961-ESHO 95 study (ClinicalTrials.gov Identifier: NCT00003052), researchers randomly assigned 341 patients with soft tissue sarcoma to 4 cycles of neoadjuvant chemotherapy (doxorubicin, ifosfamide, and etoposide) alone or with RHT every 3 weeks. Stratification was done by tumor presentation and site.

After a median follow-up of 11.3 years, 67% (220) of patients had disease relapse (95% CI, 62%-72%), and 57% (188) had died (95% CI, 52%-62%).

Patients who received RHT with chemotherapy had improved local progression-free survival (PFS) (hazard ratio [HR], 0.65; 95% CI, 0.49-0.86; P = .002) compared with chemotherapy alone.

Patients in the RHT arm also had prolonged overall survival compared with patients in the neoadjuvant therapy alone arm (HR, 0.73; 95% CI, 0.54-0.6998; P = .04).

Patients receiving RHT had a 5-year survival rate of 62.7% (95% CI, 55.2%-70.1%) compared with 51.3% (95% CI, 43.7%-59.0%) among patients who received chemotherapy alone. The 10-year survival rate for patients in the RHT arm was 52.6% (95% CI, 44.7%-60.6%) vs 42.7% (95% CI, 35.0%-50.4%) among patients who received chemotherapy alone.

The study was halted after the experimental arm showed significantly improved relapse-free and overall survival rates compared with the control.

The authors concluded that “for patients who are candidates for neoadjuvant treatment, adding RHT may be warranted.”

Reference

  1. Issels RD, Lindner LH, Verweij J, et al. Effect of neoadjuvant chemotherapy plus regional hyperthermia on long-term outcomes among patients with localized high-risk soft tissue sarcoma. JAMA Oncol. 2018 Feb 15. doi: 10.1001/jamaoncol.2017.4996 [Epub ahead of print]

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