Imatinib Mesylate in Advanced Dermatofibrosarcoma Protuberans: Pooled Analysis of Two Phase II Clinical Trials

Author:

Rutkowski Piotr1,Van Glabbeke Martine1,Rankin Cathryn J.1,Ruka Wlodzimierz1,Rubin Brian P.1,Debiec-Rychter Maria1,Lazar Alexander1,Gelderblom Hans1,Sciot Raf1,Lopez-Terrada Dolores1,Hohenberger Peter1,van Oosterom Allan T.1,Schuetze Scott M.1

Affiliation:

1. From the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; European Organisation for Research and Treatment of Cancer Headquaters, Brussels; Catholic University of Leuven, Leuven, Belgium; Leiden University Medical Centre, Leiden, the Netherlands; Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Centre, University of Heidelberg, Heidelberg, Germany; Southwest Oncology Group Statistical Center, Seattle, WA; Cleveland Clinic Foundation,...

Abstract

Purpose Dermatofibrosarcoma protuberans (DFSP) is a dermal sarcoma typically carrying a translocation between chromosomes 17 and 22 that generates functional platelet-derived growth factor B (PDGFB). Patients and Methods Two distinct phase II trials of imatinib (400 to 800 mg daily) in patients with locally advanced or metastatic DFSP were conducted and closed prematurely, one in Europe (European Organisation for Research and Treatment of Cancer [EORTC]) with 14-week progression-free rate as the primary end point and the other in North America (Southwest Oncology Group [SWOG]) with confirmed objective response rate as the primary end point. In the EORTC trial, confirmation of PDGFB rearrangement was required, and surgery was undertaken after 14 weeks if feasible. The SWOG study confirmed t(17;22) after enrollment. Results Sixteen and eight patients were enrolled onto the EORTC and SWOG trials, respectively. Tumor size ranged from 1.2 to 49 cm. DFSP was located on head/neck, trunk, and limb in seven, 11, and six patients, respectively, and was classic, pigmented, and fibrosarcomatous DFSP in 13, one, and nine patients, respectively. Metastases were present in seven patients (lung involvement was present six patients). Eleven patients (4%) had partial response as best response, and four patients had progressive disease as best response. Median time to progression (TTP) was 1.7 years. Imatinib was stopped in 11 patients because of progression, one patient because of toxicity, and two patients after complete resection of disease. Median overall survival (OS) time has not been reached; 1-year OS rate was 87.5%. Conclusion Imatinib is active in DFSP harboring t(17;22) including fibrosarcomatous DFSP, with objective response rate approaching 50%. Response rates and TTP did not differ between patients taking 400 mg daily versus 400 mg twice a day.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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