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#269 Real-life experience of pazopanib in uterine leyomiosarcoma (U-LMS) in a tertiary oncologic center in Italy: evaluation of safety and effectiveness
  1. Mara Mantiero,
  2. Monika Ducceschi,
  3. Maggie Polignano,
  4. Marta Bini,
  5. Salvatore Lopez,
  6. Chiara Cavalli,
  7. Andrea Franza,
  8. Simone Rota,
  9. Chiara Fabbroni,
  10. Francesco Raspagliesi,
  11. Paolo Giovanni Casali and
  12. Roberta Sanfilippo
  1. National Cancer Institute of Milan, Milan, Italy


Introduction/Background U-LMS is a rare entity, that needs to be referred to highly specialized sarcoma centers. Despite large number of genomic mutations in soft-tissue sarcomas no targeted-therapy is effective and systemic chemotherapy (CT) represents gold standard treatment of advanced U-LMS. The antiangiogenetic agent pazopanib is an oral multitargeted tirosine-kinase inhibitor; it demonstrated a benefit in Progression Free Survival (PFS) of 3 months in a phase III randomized PALETTE trial.

Methodology We retrospectively investigated outcomes of pazopanib in patients with metastatic U-LMS in a tertiary oncologic center in Italy. Endpoints included response rate, progression free survival (PFS) and safety.

Results From September 2013 to March 2023, 30 women with metastatic U-LMS received Pazopanib. Most patients (93%) had a good performance status (PS ECOG 0–1) and median age was 53 years old (38–72 years old). The most frequent site of metastases was lung (70%) and the median number of previous chemotherapy was 3 (range 2–5). All patients started Pazopanib at 800 mg daily; 23% of patients required dose reduction. The most common grade (G) 3 events were hepatic toxicities (HT), nausea and vomiting (7%). Two patients definitively interrupted due to drug-related toxicities: one for anasarca and one for HT. Disease control rate was 43%, with 19% of partial responses. We recorded 4 complicated responses: 1 pneumothorax, 1 intestinal perforation, 1 intestinal occlusion and 1 emoftoe due to pulmonary cavitation. In the overall population median PFS was 3 months ; in the responders subgroup was 7 (range 4–21). Four patients are still on treatment after a median period of 6 months.

Conclusion Unselected patients treated with Pazopanib in real life had a PFS and safety consistent with literature. Responder patients have a greater benefit from treatment with durable responses. However, clinicians must be careful during treatment due to the possibility of complicated response.

Disclosures No potential conflict of interest to report

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