Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors Journal Article

Authors: O'cearbhaill, R.; Zhou, Q.; Iasonos, A.; Soslow, R. A.; Leitao, M. M.; Aghajanian, C.; Hensley, M. L.
Article Title: Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors
Abstract: 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. © 2009 Elsevier Inc. All rights reserved.
Keywords: adult; clinical article; human tissue; treatment outcome; treatment response; aged; disease-free survival; middle aged; survival rate; retrospective studies; clinical trial; cancer recurrence; advanced cancer; cancer growth; drug efficacy; drug withdrawal; side effect; gemcitabine; adjuvant therapy; cancer patient; disease free survival; chemotherapy, adjuvant; temozolomide; cohort studies; neoplasm recurrence, local; breast cancer; aromatase inhibitor; vaginal dryness; medical record review; retrospective study; docetaxel; exemestane; arthralgia; asthenia; cancer hormone therapy; cancer center; cancer size; peripheral edema; tamoxifen; therapy effect; receptors, estrogen; receptors, progesterone; hot flush; letrozole; leiomyosarcoma; estrogen receptor; progesterone receptor; anastrozole; drug substitution; hormone receptor; aromatase inhibitors; uterine neoplasms; musculoskeletal disease; uterine leiomyosarcoma; megestrol acetate; uterus carcinoma; weight gain
Journal Title: Gynecologic Oncology
Volume: 116
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2010-03-01
Start Page: 424
End Page: 429
Language: English
DOI: 10.1016/j.ygyno.2009.10.064
PUBMED: 19932916
PROVIDER: scopus
PMCID: PMC4852374
Notes: --- - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Mario Leitao
    375 Leitao
  2. Qin Zhou
    142 Zhou
  3. Alexia Elia Iasonos
    215 Iasonos
  4. Martee L Hensley
    241 Hensley
  5. Robert Soslow
    718 Soslow