Redefining radiologic responses (RR) in solid tumors: Shall we brace ourselves for a post-RECIST era? Results from a randomized clinical trial (RCT) on neoadjuvant chemotherapy in high-risk soft-tissue sarcomas (HR-STS) of the trunk or extremities
Abstract
11553 Background: ISG-STS 1001, a RCT comparing anthracycline + ifosfamide (AI) vs. histology-tailored (HT) neoadjuvant chemotherapy (N) in primary localized HR-STS (G3; d >5 cm; deeply seated) showed superiority of AI, especially in the higher risk group. We report the results of the planned secondary analysis of RR. Methods: Patients (pts) with undifferentiated pleomorphic sarcoma (UPS), leiomyosarcoma (LMS), malignant peripheral nerve sheath tumor (MPNST), synovial sarcoma (SS) or myxoid liposarcoma (MLPS) were randomized, whereas pts with myxofibrosarcoma (MFS), pleomorphic liposarcoma (PLPS), pleomorphic rhabdomyosarcoma (PRMS) or unclassified sarcoma (US) were included in the observational arm (O). Pts with UPS, LMS or MLPS needing concurrent preoperative radiotherapy (RT) were included in O. Primary endpoint was Disease Free Survival (DFS). Planned secondary endpoints included Overall Survival (OS) and centrally reviewed RR per RECIST 1.1. Associations between DFS/OS and RR (per RECIST and as percent dimensional variation (D), dichotomized and continuous), DFS/OS and histology, and RR and histology were evaluated via Cox regression models. Results: 435 pts were included: 287 were randomized and 148 included in O. This analysis comprised all 236 pts with measurable disease and centrally reviewed RR. RECIST best responses were: 28 (11.9%) partial response (PR), 195 (82.6%) stable disease (SD), 13 (5.5%) progressive disease (PD). RR per RECIST significantly correlated…
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