Abstract

Although 40% of cases of soft tissue sarcoma (STS) are diagnosed in patients aged ≥65 years, this group is largely excluded from or under-represented in clinical trials and receives disproportionately less treatment than younger patients. Pooled analyses and subgroup analyses of Phase II and III randomized controlled trials of systemic therapy in advanced STS suggest the need to revisit this treatment paradigm. In various analyses, efficacy outcomes in older patients did not differ from those in younger patients or in the overall population. Available evidence supports treating elderly STS patients with similar treatment as that for younger patients. However, as some treatments are less well tolerated in older patients, safety must be considered when selecting treatment. As physiological rather than chronological age is a more appropriate criterion for treatment selection, geriatric assessment has a central role in trial design and routine clinical practice. The majority of evidence for the efficacy and safety of systemic therapy in elderly, advanced STS patients has been generated with trabectedin, which is the only agent approved for first-line use in patients unsuited to receive doxorubicin-based regimens.

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References

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Vol. 15, No. 26s

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History

Received 13 August 2019

Accepted 13 August 2019

Published online 10 September 2019

Published in print September 2019

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Acknowledgments

The article is based on a presentation at the symposium entitled ‘Addressing 3 hot topics in the management of adult soft tissue sarcoma’, held November 2018 in Rome, Italy, within the framework of the Annual Meeting of the Connective Tissue Oncology Society.

Financial & competing interests disclosure

RL Jones is a consultant for Adaptimmune, Blueprint, Clinigen, Eisai, Epizyme, Daichii, Deciphera, Immunedesign, Lilly, Merck, PharmaMar and Tracon. The Royal Marsden NHS Foundation Trust is supported by the Royal Marsden Hospital Cancer Charity and Biomedical Research Centre of the Royal Marsden and the Institute of Cancer Research. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance for this article was provided by K Dechant on behalf of Content Ed Net (Madrid, Spain) with funding from PharmaMar, Madrid, Spain.

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Sarcomas and old age: few options for such a large patient population

Abstract

References