Faculty Collaboration Database

Validation of prognostic scoring and assessment of clinical benefit for patients with bone sarcomas enrolled in phase I clinical trials. Oncotarget 2016 Sep 27;7(39):64421-64430

Date

08/04/2016

Pubmed ID

27486883

Pubmed Central ID

PMC5325454

DOI

10.18632/oncotarget.10910

Scopus ID

2-s2.0-84993982633 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

BACKGROUND: We sought to validate the Royal Marsden Hospital (RMH) and MD Anderson Cancer Center (MDACC) prognostic scoring systems for the selection of bone sarcoma patients for phase I clinical trials and to identify additional risk factors related to survival.

PATIENTS AND METHODS: We retrospectively reviewed the baseline characteristics and outcomes of 92 bone sarcoma patients who were referred to MDACC's Phase I Clinical Trials Program.

RESULTS: Ninety-two patients with Ewing sarcoma (N = 47), osteosarcoma (N = 22), chondrosarcoma (N = 16), and other tumors (N = 7) were evaluated; 78 were enrolled in at least 1 of 43 different phase I trials. The median overall survival (OS) was 8.8 months (95% confidence interval [CI] = 6.8-13.7 months). Independent factors that predicted shorter survival were male sex, >2 metastatic sites, >3 previous therapies, hemoglobin level <10.5 g/dL, platelet count >200 x103/L, creatinine level ≥1.3 mg/dL, and lactate dehydrogenase level >ULN. Patients with good RMH scores (0-1) had longer OS than patients with poor RMH scores (2-3) (HR = 5.8, 95% CI = 2.9-11.0; P < 0.0001), as did patients with low MDACC scores (0-1) as compared to patients with higher MDACC scores (2-4) (HR = 3.2, 95% CI = 1.9-5.6; P < 0.0001).

CONCLUSION: The RMH prognostic score can be used to predict the OS of bone cancer patients referred for phase I trials. The MDACC score added no value to the RMH score and therefore does not have a role in assessment of patients with bone tumors. Patients with advanced bone sarcomas should be considered for phase I trials.

Author List

Livingston JA, Hess KR, Naing A, Hong DS, Patel S, Benjamin RS, Ludwig JA, Conley A, Herzog CE, Anderson P, Meric-Bernstam F, Kurzrock R, Subbiah V

Author

Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Bone Neoplasms
Child
Chondrosarcoma
Clinical Decision-Making
Clinical Trials, Phase I as Topic
Decision Support Techniques
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Osteosarcoma
Patient Selection
Predictive Value of Tests
Proportional Hazards Models
Reproducibility of Results
Retrospective Studies
Risk Assessment
Risk Factors
Sarcoma, Ewing
Time Factors
Treatment Outcome
Young Adult