Long-Term Outcome of Neoadjuvant Tyrosine Kinase Inhibitors Followed by Complete Surgery in Locally Advanced Dermatofibrosarcoma Protuberans.
Jessica BeazizMaxime BattistellaJulie DelyonCécile FargesOren MarcoCécile PagesChristine Le MaignanLaetitia Da MedaNicole Basset-SeguinMatthieu Resche-RigonAnouk Walter PetrichDelphine KérobCéleste LebbéBarouyr BaroudjianPublished in: Cancers (2021)
In locally advanced dermatofibrosarcoma protuberans (DFSP), imatinib mesylate has been described as an efficient neoadjuvant therapy. This retrospective study included patients with locally advanced DFSP who received neoadjuvant TKI (imatinib or pazopanib) from 2007 to 2017 at Saint Louis Hospital, Paris. The primary endpoint was the evaluation of the long-term status. A total of 27 patients were included, of whom nine had fibrosarcomatous transformation. The median duration of treatment was 7 months. The best response to TKI treatment before surgery, evaluated according to RECIST1.1 on MRI, consisted of complete/partial response (38.5%) or stability (46.2%). DFSP was surgically removed in 24 (89%) patients. A total of 23 patients (85%) were disease-free after 64.8 months of median follow-up (95% confidence interval 47.8; 109.3). One patient developed distant metastases 37 months after surgical tumor resection and finally died. Two patients (7%) did not get surgery because of metastatic progression during TKI treatment, and one patient refused surgery even though the tumor decreased by 30%. Treatment-related adverse events (AE) occurred in 23 patients (85%). Only four patients (imatinib: n = 3, pazopanib: n = 1) had grade ≥3 AE requiring temporary treatment disruption. Neoadjuvant TKI followed by complete surgery with micrographic analysis is an effective strategy for locally advanced and unresectable DFSP, with durable local recurrence disease-free survival.
Keyphrases
- locally advanced
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- minimally invasive
- squamous cell carcinoma
- magnetic resonance imaging
- clinical trial
- healthcare
- free survival
- lymph node
- radiation therapy
- coronary artery bypass
- patient reported outcomes
- neoadjuvant chemotherapy
- coronary artery disease
- percutaneous coronary intervention
- case report
- advanced non small cell lung cancer
- magnetic resonance
- epidermal growth factor receptor
- data analysis
- acute care