Hand-foot skin reaction predicts treatment outcome of pazopanib in patients with metastatic soft tissue sarcoma: A multicenter study in the Asian population

Asia Pac J Clin Oncol. 2018 Aug;14(4):353-360. doi: 10.1111/ajco.13029. Epub 2018 Jun 13.

Abstract

Aim: Pazopanib is a multitargeted tyrosine kinase inhibitor used as a standard treatment for chemotherapy-refractory recurrent or metastatic soft tissue sarcoma. This study aimed to evaluate the efficacy and safety of pazopanib for treatment of metastatic soft tissue sarcoma in the Asian population.

Methods: Fifty patients with chemotherapy-refractory recurrent or metastatic soft tissue sarcoma, who had received pazopanib treatment between 2015 and 2016 were enrolled. We reviewed patients' clinical characteristics and studied survival outcomes following pazopanib treatment.

Results: Median follow-up was 5.7 months. Seven patients were still on pazopanib by the end of this study and the disease had progressed in the other 43 patients, leading to 23 deaths. We found that despite treatment more than half the patients experienced disease progression (56% vs 14% partial response and 30% stable disease). The median progression-free survival and overall survival was 3.1 and 11.0 months, respectively. Multivariate analysis identified good Eastern Cooperative Oncology Group performance status (0 or 1) and occurrence of hand-foot skin reaction as independent factors associated with better outcome. Hand-foot skin reaction was 32% in our cohort and the median onset time was 4 (1.00-8.29) weeks. It had dose-dependent effect by clinical observation.

Conclusions: Our study showed that the incidence rate of hand-foot skin reaction in Taiwan is higher than western population, and it is an independent predictive factor for better treatment outcomes.

Keywords: chemotherapy-refractory sarcoma; hand-foot skin reaction; pazopanib; soft tissue sarcoma; tyrosine kinase inhibitor.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Asian People
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Hand-Foot Syndrome / etiology*
  • Humans
  • Indazoles
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use*
  • Retrospective Studies
  • Sarcoma / drug therapy*
  • Sarcoma / pathology
  • Sulfonamides / adverse effects
  • Sulfonamides / therapeutic use*
  • Taiwan
  • Treatment Outcome

Substances

  • Indazoles
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • pazopanib