The intriguing patterns of tumor response to trabectedin

Abstract

Among soft tissue sarcomas, myxoid liposarcomas are exceedingly sensitive to trabectedin. Obvious tumor shrinkage is seen in some patients, whereas nondimensional changes in tumor tissue are seen in others especially after the first cycles of therapy. These patterns of tumor response are reminiscent of the way in which solid tumors respond to targeted therapies. The finding of trabectedin’s ability to target the FUS-CHOP-mediated transcriptional block, restoring adipogenic differentiation within the tumor in myxoid liposarcomas, confirmed a ‘targeted’ activity that differs from its well-known atypical alkylating mechanism of action. Uterine leiomyosarcoma may show similar patterns of dimensional and nondimensional responses to trabectedin. Unusual cases of delayed response are occasionally seen and suggest other mechanisms of action, including activity on the tumor microenvironment which has recently been reported. An intriguing question is whether the different patterns of response have clinically or therapeutically meaningful correlations.

Keywords::

• choi criteria
• dimensional response
• immunomodulation
• leiomyosarcoma
• myxoid liposarcoma
• nondimensional response
• response criteria
• targeted therapy
• trabectedin

Financial & competing interests disclosure

R Sanfilippo has received travel coverage from PharmaMar S.A. for medical meetings. PG Casali has received honoraria for an advisory role and invited lectures, and has received travel coverage for medical meetings, from PharmaMar S.A. The authors have 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..

Editorial assistance was provided by Content Ed Net (Madrid, Spain).

Informed consent disclosure

The authors state that they obtained verbal informed consent from the patient for inclusion of her medical and treatment history.