Long-Term Progression-Free Survival in a Patient with Metastatic Leiomyosarcoma of the Inguinal Region Treated with Trabectedin

Abstract

Presented here is the case of an elderly leiomyosarcoma patient with multiple comorbidities and relapses from prior lines of treatment, who experienced a long-lasting progression-free survival. After initial diagnosis, standard treatment protocols with surgery and subsequent adjuvant radiochemotherapy were administered, followed by a short course of oral pazopanib at the patient's request, which led to a rapid relapse. Afterwards, the patient received trabectedin for 22 months, achieving disease control with good quality of life over an extended period of time. After progression from trabectedin, the patient was switched to eribulin. Future clinical trials are needed to investigate the efficacy of trabectedin maintenance treatment and to identify predictive criteria for response to trabectedin among patients with advanced sarcoma.

Keywords: Alkylating agent; Leiomyosarcoma; Metastatic disease; Partial response; Progression-free survival; Soft tissue sarcoma; Trabectedin.

Fig. 1.

Overview of diagnostic and therapeutic measures and outcomes over time. CT, computed tomography; MRI, magnetic resonance imaging; PD, progressive disease; PR, partial remission; RTx, radiotherapy; SD, stable disease.

Fig. 2.

Abdominal CT images during trabectedin treatment. a Disease progression after pazopanib treatment. b Second diagnosis of partial remission after 6.5 months of trabectedin treatment (first partial remission observed after 3 months of trabectedin). c Disease progression after 22 months of trabectedin treatment. CT, computed tomography; PD, progressive disease; PR, partial remission.