Pathologic complete response in patients with localized soft tissue sarcoma treated with neoadjuvant therapy and its correlation with clinical outcomes: A systematic review

IF 11.3 1区化学 Q1 CHEMISTRY, PHYSICAL

ACS Catalysis Pub Date : 2024-08-24 DOI:10.1016/j.ctrv.2024.102820

A. Boulouta , A. Kyriazoglou , I. Kotsantis , P. Economopoulou , M. Anastasiou , A. Pantazopoulos , M. Kyrkasiadou , M. Moutafi , N. Gavrielatou , E. Zazas , C. Caglar , I. Nixon , M. Tolia , G. Kavourakis , A. Psyrri

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引用次数: 0

Abstract

Soft tissue sarcomas (STS), comprising approximately 1% of adult solid malignancies, are primarily treated with surgery, with the choice of perioperative treatment being a challenging and highly individualized decision. Clinical trials assessing neoadjuvant modalities in STS predominantly use clinical outcomes or radiologic response as endpoints, with pathologic complete response (pCR) not being employed as a designated study endpoint. Our systematic review aimed to assess the rates of pCR in clinical trials of different neoadjuvant modalities for STS and its correlation with patient clinical outcomes. 23 phase I, II and III studies were included, from which data regarding rates of pCR with each treatment, as well as correlation of pCR with clinical outcomes were retrieved. In 16 trials that assessed pCR, the percentage of patients who achieved a pCR ranged from 8 to 58%. Most of these trials did not aim to establish an association between pCR and clinical outcomes. However, among those that did investigate this correlation, a positive association was identified between pCR and both 5-year disease-specific survival (DSS) and 5-year overall survival (OS). While pCR serves as a crucial marker guiding treatment decisions in other neoplasms like triple negative breast cancer and urothelial cancer, it is not yet used in a similar setting for STS. Our findings indicate variability in patients achieving pCR across different neoadjuvant treatments for STS and a possible positive correlation with patient outcomes. Consequently, we propose considering pCR as a surrogate endpoint in future prospective trials for STS.

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接受新辅助治疗的局部软组织肉瘤患者的病理完全反应及其与临床结果的相关性：系统综述

软组织肉瘤（STS）约占成人实体恶性肿瘤的 1%，主要采用手术治疗，围手术期治疗方法的选择是一项极具挑战性且高度个性化的决定。评估STS新辅助治疗模式的临床试验主要以临床结果或放射学反应作为终点，病理完全反应（pCR）并未作为指定的研究终点。我们的系统性综述旨在评估STS不同新辅助方法临床试验中的pCR率及其与患者临床结果的相关性。我们纳入了 23 项 I、II 和 III 期研究，从中检索了每种治疗方法的 pCR 率数据，以及 pCR 与临床预后的相关性。在 16 项评估 pCR 的试验中，获得 pCR 的患者比例从 8% 到 58% 不等。这些试验中的大多数并不旨在建立 pCR 与临床结果之间的关联。不过，在那些研究了这种相关性的试验中，发现 pCR 与 5 年疾病特异性生存（DSS）和 5 年总生存（OS）之间存在正相关。虽然 pCR 是指导其他肿瘤（如三阴性乳腺癌和尿路上皮癌）治疗决策的重要标志物，但它尚未用于类似的 STS。我们的研究结果表明，在不同的 STS 新辅助治疗中，患者获得 pCR 的情况各不相同，而且可能与患者的预后呈正相关。因此，我们建议在未来的 STS 前瞻性试验中将 pCR 作为替代终点。

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来源期刊

ACS Catalysis CHEMISTRY, PHYSICAL-

CiteScore

20.80

自引率

6.20%

发文量

1253

审稿时长

1.5 months

期刊介绍： ACS Catalysis is an esteemed journal that publishes original research in the fields of heterogeneous catalysis, molecular catalysis, and biocatalysis. It offers broad coverage across diverse areas such as life sciences, organometallics and synthesis, photochemistry and electrochemistry, drug discovery and synthesis, materials science, environmental protection, polymer discovery and synthesis, and energy and fuels. The scope of the journal is to showcase innovative work in various aspects of catalysis. This includes new reactions and novel synthetic approaches utilizing known catalysts, the discovery or modification of new catalysts, elucidation of catalytic mechanisms through cutting-edge investigations, practical enhancements of existing processes, as well as conceptual advances in the field. Contributions to ACS Catalysis can encompass both experimental and theoretical research focused on catalytic molecules, macromolecules, and materials that exhibit catalytic turnover.