A Growth Modulation Index-Based GEISTRA Score as a New Prognostic Tool for Trabectedin Efficacy in Patients with Advanced Soft Tissue Sarcomas: A Spanish Group for Sarcoma Research (GEIS) Retrospective Study

• Published in: Cancers Vol. 13; no. 4; p. 792
• Main Authors: Martínez-Trufero, Javier, De Sande-González, Luis Miguel, Luna, Pablo, Martin-Broto, Javier, Álvarez, Rosa, Marquina, Gloria, Diaz-Beveridge, Roberto, Poveda, Andrés, Cano, Juana María, Cruz-Jurado, Josefina, López Pousa, Antonio, Vaz Salgado, María Angeles, Valverde-Morales, Claudia M, Sevilla, Isabel, Martínez-García, Jerónimo, Rubio-Casadevall, Jordi, De Juan, Ana, Carrasco, Juan Antonio, Moura, David S, Gurruchaga-Sotes, Ibon, Gutiérrez, Antonio
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14-02-2021; MDPI
• Subjects: Chemotherapy; Clinical medicine; Medical prognosis; Metastases; Metastasis; Patients; Sarcoma; Soft tissue sarcoma; Survival; Survival analysis; Variables; Spain; prognostic score; growth modulation index; sarcoma; trabectedin; L-sarcoma; GEISTRA
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13040792

The aim of this study was to identify an easily reliable prognostic score that selects the subset of advanced soft tissue sarcoma (ASTS) patients with a higher benefit with trabectedin in terms of time to progression and overall survival. A retrospective series of 357 patients with ASTS treated with trabectedin as second- or further-line in 19 centers across Spain was analyzed. First, it was confirmed that patients with high growth modulation index (GMI > 1.33) were associated with the better clinical outcome. Univariate and multivariate analyses were performed to identify factors associated with a GMI > 1.33. Thus, GEISTRA score was based on metastasis free-interval (MFI ≤ 9.7 months), Karnofsky < 80%, Non L-sarcomas and better response in the previous systemic line. The median GMI was 0.82 (0-69), with 198 patients (55%) with a GMI < 1, 41 (11.5%) with a GMI 1-1.33 and 118 (33.1%) with a GMI > 1.33. The lowest GEISTRA score showed a median of time-to-progression (TTP) and overall survival (OS) of 5.7 and 19.5 months, respectively, whereas it was 1.8 and 3.1 months for TTP and OS, respectively, for the GEISTRA 4 score. This prognostic tool can contribute to better selecting candidates for trabectedin treatment in ASTS.