Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center

Background/Objectives: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford...

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Main Authors: Ted Kim, Clara Hao, Minggui Pan, Kristen N. Ganjoo, Nam Q. Bui
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/13/3/79
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author Ted Kim
Clara Hao
Minggui Pan
Kristen N. Ganjoo
Nam Q. Bui
author_facet Ted Kim
Clara Hao
Minggui Pan
Kristen N. Ganjoo
Nam Q. Bui
author_sort Ted Kim
collection DOAJ
description Background/Objectives: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center. Methods: Seventy-four patients with unresectable or metastatic LMS were deemed eligible and treated with first-line chemotherapy regimens, including gemcitabine plus docetaxel, dacarbazine, doxorubicin combinations (with evofosfamide or ifosfamide), and doxorubicin monotherapy. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) were assessed using RECIST v1.1, with survival analyses performed using Kaplan–Meier and Cox proportional hazards methods. Results: The cohort consisted of 56 females (75.7%) and 18 males (24.3%), with a median age of 55.5 years. The majority (93.2%) had metastatic disease. The median PFS for the entire cohort was 4.9 months (range: 0.6–28.1 mo), and the median OS was 27.3 months (range: 1.9–140.2 mo). The doxorubicin combination (DC) group had the highest median PFS of 7.9 months (range: 0.6–15.8 mo). Doxorubicin alone had the highest median OS of 33.8 months (4.2–100.2 mo). Doxorubicin combinations demonstrated superior PFS in both uterine and non-uterine LMS subgroups. Conclusions: These findings reaffirm the efficacy of doxorubicin-based combination regimens as a first-line treatment for locally advanced and metastatic LMS, particularly in non-uterine LMS.
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spelling doaj-art-e1ee2dc463c54de8933ed1b36eb9f9112025-08-20T03:43:15ZengMDPI AGDiseases2079-97212025-03-011337910.3390/diseases13030079Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma CenterTed Kim0Clara Hao1Minggui Pan2Kristen N. Ganjoo3Nam Q. Bui4Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, USADivision of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, USADivision of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, USADivision of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, USADivision of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, USABackground/Objectives: Locally advanced and metastatic leiomyosarcoma (LMS) is an aggressive cancer with limited treatment options. This single-institution, retrospective study evaluated the efficacy of first-line chemotherapy regimens in patients with advanced or metastatic LMS treated at Stanford Medical Center. Methods: Seventy-four patients with unresectable or metastatic LMS were deemed eligible and treated with first-line chemotherapy regimens, including gemcitabine plus docetaxel, dacarbazine, doxorubicin combinations (with evofosfamide or ifosfamide), and doxorubicin monotherapy. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) were assessed using RECIST v1.1, with survival analyses performed using Kaplan–Meier and Cox proportional hazards methods. Results: The cohort consisted of 56 females (75.7%) and 18 males (24.3%), with a median age of 55.5 years. The majority (93.2%) had metastatic disease. The median PFS for the entire cohort was 4.9 months (range: 0.6–28.1 mo), and the median OS was 27.3 months (range: 1.9–140.2 mo). The doxorubicin combination (DC) group had the highest median PFS of 7.9 months (range: 0.6–15.8 mo). Doxorubicin alone had the highest median OS of 33.8 months (4.2–100.2 mo). Doxorubicin combinations demonstrated superior PFS in both uterine and non-uterine LMS subgroups. Conclusions: These findings reaffirm the efficacy of doxorubicin-based combination regimens as a first-line treatment for locally advanced and metastatic LMS, particularly in non-uterine LMS.https://www.mdpi.com/2079-9721/13/3/79leiomyosarcomasoft tissue sarcomachemotherapydoxorubicinprogression-free survivaloverall survival
spellingShingle Ted Kim
Clara Hao
Minggui Pan
Kristen N. Ganjoo
Nam Q. Bui
Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
Diseases
leiomyosarcoma
soft tissue sarcoma
chemotherapy
doxorubicin
progression-free survival
overall survival
title Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
title_full Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
title_fullStr Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
title_full_unstemmed Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
title_short Gemcitabine Plus Docetaxel, Dacarbazine, Doxorubicin Combinations, or Doxorubicin Alone as First-Line Treatment for Advanced/Metastatic Leiomyosarcoma: A Retrospective Analysis at a Sarcoma Center
title_sort gemcitabine plus docetaxel dacarbazine doxorubicin combinations or doxorubicin alone as first line treatment for advanced metastatic leiomyosarcoma a retrospective analysis at a sarcoma center
topic leiomyosarcoma
soft tissue sarcoma
chemotherapy
doxorubicin
progression-free survival
overall survival
url https://www.mdpi.com/2079-9721/13/3/79
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