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Case Reports
. 2015 Dec 22:15:998.
doi: 10.1186/s12885-015-2038-7.

Long-lasting activity of trabectedin in refractory uterine leiomyosarcoma: a case report

Alberto Bongiovanni  1 , Nada Riva  2 , Marianna Ricci  3 , Laura Mercatali  4 , Chiara Liverani  5 , Federico La Manna  6 , Alessandro De Vita  7 , Davide Cavaliere  8 , Federica Pieri  9 , Devil Oboldi  10 , Giorgio Maria Verdecchia  11 , Dino Amadori  12 , Toni Ibrahim  13
Affiliations
Case Reports

Long-lasting activity of trabectedin in refractory uterine leiomyosarcoma: a case report

Alberto Bongiovanni et al. BMC Cancer. .

Abstract

Background: Leiomyosarcoma (LMS) is an aggressive soft tissue sarcoma derived from smooth muscle cells typically of uterine, gastrointestinal or soft tissue origin. The prognosis for this tumor is poor, with survival rates among the lowest of all soft tissue sarcomas. Surgery is the best approach for localized disease. The principal role of chemotherapy is prevalently in the treatment of metastatic disease. Trabectedin, a promising new DNA-damaging agent with a mechanism of action that differs from that of traditional alkylating agents, has been approved in Europe for the treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide,

Case presentation: We report the case of a 53-year-old woman with metastatic well differentiated uterine leiomyosarcoma refractory to multiple treatments who underwent 22 cycles of trabectedin over 30 months, obtaining a partial response according to RECIST (Response Evaluation Criteria in Solid Tumors) criteria, with good tolerability, and maintaining the response for 10 months after trebectedin withdrawal.

Conclusion: This very prolonged response, which persisted after drug discontinuation, suggests that trabectedin exerts an oncostatic effect rather than the cytotoxic one produced by other chemotherapeutic agents. Our experience also raises the question of the best way to evaluate trabectedin efficacy.

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Figures

Fig. 1
Fig. 1
January 2011: CT scan showing peritoneal progression after gemcitabine
Fig. 2
Fig. 2
July 2012 (11 months after the start of treatment): CT scan showing a reduction in the size of the abdominal lesions
Fig. 3
Fig. 3
September 2013: CT scan showing abdominal progression with an increase in the size of the peritoneal lesions
See this image and copyright information in PMC

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