Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial
Background: Chemoimmunotherapy is safe and efficacious in treating many types of malignant tumors. However, clinical data demonstrating the effect of this combination treatment in patients with metastatic soft tissue sarcoma (STS) are currently limited. This study evaluated the safety and efficacy o...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.987569/full |
| _version_ | 1811200969177825280 |
|---|---|
| author | Zhichao Tian Shuping Dong Wenli Zuo Po Li Fan Zhang Shilei Gao Yonghao Yang Chao Li Peng Zhang Xin Wang Jiaqiang Wang Weitao Yao |
| author_facet | Zhichao Tian Shuping Dong Wenli Zuo Po Li Fan Zhang Shilei Gao Yonghao Yang Chao Li Peng Zhang Xin Wang Jiaqiang Wang Weitao Yao |
| author_sort | Zhichao Tian |
| collection | DOAJ |
| description | Background: Chemoimmunotherapy is safe and efficacious in treating many types of malignant tumors. However, clinical data demonstrating the effect of this combination treatment in patients with metastatic soft tissue sarcoma (STS) are currently limited. This study evaluated the safety and efficacy of a programmed cell death protein 1 (PD-1) inhibitor plus doxorubicin in patients with advanced STS who failed previous systemic therapy.Methods: This was a single-center, single-arm, open-label phase II trial. Patients with unresectable or metastatic STS who had previously failed systemic therapy were enrolled. Patients received up to six cycles of doxorubicin and sintilimab (a PD-1 inhibitor), while sintilimab treatment continued for up to 2 years. Primary outcomes were objective response rate (ORR) and safety. Univariate Cox proportional hazards model was used to analyze the relationship between clinicopathological parameters and progression-free survival (PFS).Results: A total of 38 patients (20 men and 18 women) were enrolled in this study. The overall ORR was 39.5%, disease control rate was 71.1%, and the median PFS was 4.5 months [95% confidence interval (CI), 3.0–8.5 months]. The adverse events (AEs) associated with the combined treatment were mild, manageable, and well-tolerated. The most common grade 3 or higher AEs were hematologic, including leukopenia (21.1%), anemia (18.4%), and thrombocytopenia (18.4%). Patients with undifferentiated pleomorphic sarcoma (UPS) or dedifferentiated liposarcoma had a significantly longer PFS than those with other pathological subtypes [hazard ratio (HR) = 0.42, 95% CI 0.21–0.83; p = 0.013]. There was no significant difference in the median PFS between patients who had previously received anthracycline-based chemotherapy and those who had not (HR = 0.74, 95% CI 0.34–1.58, p = 0.43).Conclusion: Sintilimab plus doxorubicin is a safe and promising treatment for patients with advanced STS who have failed previous systemic therapy (including anthracycline-based chemotherapy). The efficacy of this combination therapy in UPS and dedifferentiated liposarcoma is superior to that in other sarcomas.Clinical Trial Registration:https://www.chictr.org.cn, registration number: ChiCTR1900027009. |
| first_indexed | 2024-04-12T02:13:39Z |
| format | Article |
| id | doaj.art-b1901da324fd4e09b78fb0c644990e87 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T02:13:39Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-b1901da324fd4e09b78fb0c644990e872022-12-22T03:52:19ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-10-011310.3389/fphar.2022.987569987569Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trialZhichao Tian0Shuping Dong1Wenli Zuo2Po Li3Fan Zhang4Shilei Gao5Yonghao Yang6Chao Li7Peng Zhang8Xin Wang9Jiaqiang Wang10Weitao Yao11Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University, Henan, Zhengzhou, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaBackground: Chemoimmunotherapy is safe and efficacious in treating many types of malignant tumors. However, clinical data demonstrating the effect of this combination treatment in patients with metastatic soft tissue sarcoma (STS) are currently limited. This study evaluated the safety and efficacy of a programmed cell death protein 1 (PD-1) inhibitor plus doxorubicin in patients with advanced STS who failed previous systemic therapy.Methods: This was a single-center, single-arm, open-label phase II trial. Patients with unresectable or metastatic STS who had previously failed systemic therapy were enrolled. Patients received up to six cycles of doxorubicin and sintilimab (a PD-1 inhibitor), while sintilimab treatment continued for up to 2 years. Primary outcomes were objective response rate (ORR) and safety. Univariate Cox proportional hazards model was used to analyze the relationship between clinicopathological parameters and progression-free survival (PFS).Results: A total of 38 patients (20 men and 18 women) were enrolled in this study. The overall ORR was 39.5%, disease control rate was 71.1%, and the median PFS was 4.5 months [95% confidence interval (CI), 3.0–8.5 months]. The adverse events (AEs) associated with the combined treatment were mild, manageable, and well-tolerated. The most common grade 3 or higher AEs were hematologic, including leukopenia (21.1%), anemia (18.4%), and thrombocytopenia (18.4%). Patients with undifferentiated pleomorphic sarcoma (UPS) or dedifferentiated liposarcoma had a significantly longer PFS than those with other pathological subtypes [hazard ratio (HR) = 0.42, 95% CI 0.21–0.83; p = 0.013]. There was no significant difference in the median PFS between patients who had previously received anthracycline-based chemotherapy and those who had not (HR = 0.74, 95% CI 0.34–1.58, p = 0.43).Conclusion: Sintilimab plus doxorubicin is a safe and promising treatment for patients with advanced STS who have failed previous systemic therapy (including anthracycline-based chemotherapy). The efficacy of this combination therapy in UPS and dedifferentiated liposarcoma is superior to that in other sarcomas.Clinical Trial Registration:https://www.chictr.org.cn, registration number: ChiCTR1900027009.https://www.frontiersin.org/articles/10.3389/fphar.2022.987569/fullPD-1 inhibitorchemotherapychemoimmunotherapyundifferentiated pleomorphic sarcomadedifferentiated liposarcoma |
| spellingShingle | Zhichao Tian Shuping Dong Wenli Zuo Po Li Fan Zhang Shilei Gao Yonghao Yang Chao Li Peng Zhang Xin Wang Jiaqiang Wang Weitao Yao Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial Frontiers in Pharmacology PD-1 inhibitor chemotherapy chemoimmunotherapy undifferentiated pleomorphic sarcoma dedifferentiated liposarcoma |
| title | Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial |
| title_full | Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial |
| title_fullStr | Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial |
| title_full_unstemmed | Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial |
| title_short | Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial |
| title_sort | efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma a single arm phase ii trial |
| topic | PD-1 inhibitor chemotherapy chemoimmunotherapy undifferentiated pleomorphic sarcoma dedifferentiated liposarcoma |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.987569/full |
| work_keys_str_mv | AT zhichaotian efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT shupingdong efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT wenlizuo efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT poli efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT fanzhang efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT shileigao efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT yonghaoyang efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT chaoli efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT pengzhang efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT xinwang efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT jiaqiangwang efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial AT weitaoyao efficacyandsafetyofsintilimabplusdoxorubicininadvancedsofttissuesarcomaasinglearmphaseiitrial |