Introduction/Background Due to limited life expectancy in uterine sarcomas, it is mandatory to achieve a high therapeutic index. Doxorubicin combined with trabectedin is considered to improve progression-free survival (PFS) compared to single-agent use of doxorubicin despite higher toxicity. We assume a higher therapeutic index positively affecting quality of life when treating with pegylated liposomal doxorubicin (PLD) combined with trabectedin.

Methodology In total, 21 patients with uterine sarcomas treated with PLD 30 mg/m2 plus trabectedin 1.1 mg/m2 every three weeks between January 2000 and April 2023 at the University Hospital in Innsbruck were included in this retrospective single-arm study. Response to treatment was assessed every three cycles and every three months during the follow-up. Toxicity was evaluated according to the National Cancer Institute-Common Terminology criteria, on a total of 148 administered cycles in 33 patients.

Results Regarding grade 3/4 toxicity, thrombocytopenia were recorded in 9%, anaemia in 12% and neutropenia in 36% of patients. Febrile neutropenia was present in 21% of patients. In summary, toxicity resulted in 17% of cycles in a dose delay and in 5.4% in a dose reduction. After three cycles one patient (4.8%) achieved complete remission (CR) and nine patients (43%) partial remission (PR) resulting in an objective response rate (ORR) of 48%. Three patients (14%) showed stable disease (SD), resulting in a clinical benefit rate (=OOR+SD) of 62%. Unfortunately, the results were not translatable to the response evaluation after 6 months with an ORR of 24% and a CBR of 43%. Median PFS was 6.0 months (SD:±21 months), while median overall survival was 26 months (SD:±32 months).

Conclusion The treatment investigated here is a feasible option for uterine sarcomas, as it presents a more favourable toxicity profile when compared to doxorubicin plus trabectedin. Although the CBR is limited, it is still similar to that of the current standard.

Disclosures no disclosures