Soft Tissue Sarcoma with Jonathan C. Trent, MD, PhD and Shreyaskumar R. Patel, MD: Case 1 - Episode 6
What additional options are available for durable response in this patient to stabilize her metastatic disease?
The critical word in that question may be "durable." Durable is going to be variably defined by each individual. If you look at durable responses in the traditional definition, it would last at least a few months. That is a very conservative definition to begin with, and I don't think the patient has any standard therapy options. She could try ifosamide, though the pros and cons of the treatment are many.
The current practice treatment tends to be to take this patient's tumor tissue to see if you can find a target that can be addressed with a specific inhibitor. If so, then a medical professional could try to match that patient to a phase I clinical trial, which may be the best option. There is data out there that suggests that rather than trying an empiric phase I clinical trial, which could be a reasonable option for this patient if she was willing to consider it, is matching them to a targeted therapy rather than picking one empirically.
CASE: Soft-Tissue Sarcoma (Part 1)
Rachel F is a 58-year-old school teacher from Roanoke, Virginia. Her medical history is notable for mild hypertension and total knee replacement in 2011
Follow-up CT scan in January 2014 showed progression at multiple sites; at the time of follow up, her ECOG performance status was 1, with renal and hepatic function within normal limits
In September of 2014 she returns for follow-up, unable to work with increasing fatigue and abdominal pain, and her CT scan was consistent with progressive disease
After 4 months of therapy, she presents with worsening abdominal pain and declining performance status