BACKGROUND: Aromatase inhibitors are sometimes used in the treatment of selected patients with uterine leiomyosarcoma (LMS), but there are few data assessing the efficacy of aromatase inhibitors in this setting. METHODS: We performed a retrospective electronic medical record review of patients with uterine LMS treated with an aromatase inhibitor at Memorial Sloan-Kettering Cancer Center between 1998 and 2008. We assessed progression-free survival (PFS) and objective response among patients with measurable disease and explored the correlation of hormone receptor status with outcome. RESULTS: Forty patients with advanced or recurrent uterine LMS were treated with aromatase inhibitors. Thirty-four patients had measurable disease. Hormone receptor status for these patients was as follows: estrogen receptor (ER) positive-22, ER negative-9, ER unknown-3, progesterone receptor (PR) positive-10, PR negative-10, PR unknown-14. Aromatase inhibitors used were letrozole (in 74% of patients), anastrozole (21%), and exemestane (6%). Median PFS was 2.9 months (95% CI: 1.8-5.1). The 1-year PFS rate was 28% (95% CI: 11-48%) for ER and/or PR positive uterine LMS. Best objective response was partial response (PR) in 3/34 patients (9%) (all of whom were ER positive). CONCLUSIONS: In this population of patients with mostly low-volume and ER positive uterine LMS, aromatase inhibitors achieved objective response in only 9%. Relatively prolonged PFS was observed among ER positive uterine LMS patients. In the absence of a no-treatment control group, the prolonged PFS cannot be attributed solely to the activity of the aromatase inhibitor treatment since it may reflect the underlying biology of low-volume, ER positive uterine LMS.
BACKGROUND:Aromatase inhibitors are sometimes used in the treatment of selected patients with uterine leiomyosarcoma (LMS), but there are few data assessing the efficacy of aromatase inhibitors in this setting. METHODS: We performed a retrospective electronic medical record review of patients with uterine LMS treated with an aromatase inhibitor at Memorial Sloan-Kettering Cancer Center between 1998 and 2008. We assessed progression-free survival (PFS) and objective response among patients with measurable disease and explored the correlation of hormone receptor status with outcome. RESULTS: Forty patients with advanced or recurrent uterine LMS were treated with aromatase inhibitors. Thirty-four patients had measurable disease. Hormone receptor status for these patients was as follows: estrogen receptor (ER) positive-22, ER negative-9, ER unknown-3, progesterone receptor (PR) positive-10, PR negative-10, PR unknown-14. Aromatase inhibitors used were letrozole (in 74% of patients), anastrozole (21%), and exemestane (6%). Median PFS was 2.9 months (95% CI: 1.8-5.1). The 1-year PFS rate was 28% (95% CI: 11-48%) for ER and/or PR positive uterine LMS. Best objective response was partial response (PR) in 3/34 patients (9%) (all of whom were ER positive). CONCLUSIONS: In this population of patients with mostly low-volume and ER positive uterine LMS, aromatase inhibitors achieved objective response in only 9%. Relatively prolonged PFS was observed among ER positive uterine LMS patients. In the absence of a no-treatment control group, the prolonged PFS cannot be attributed solely to the activity of the aromatase inhibitor treatment since it may reflect the underlying biology of low-volume, ER positive uterine LMS.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
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Authors: F J Major; J A Blessing; S G Silverberg; C P Morrow; W T Creasman; J L Currie; E Yordan; M F Brady Journal: Cancer Date: 1993-02-15 Impact factor: 6.860
Authors: Martee L Hensley; Brigitte A Barrette; Klaus Baumann; David Gaffney; Anne L Hamilton; Jae-Weon Kim; Johanna U Maenpaa; Patricia Pautier; Nadeem Ahmad Siddiqui; Anneke M Westermann; Isabelle Ray-Coquard Journal: Int J Gynecol Cancer Date: 2014-11 Impact factor: 3.437