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Soft Tissue Tumors

(P 319) CARDIOTOXICITY AND OVERALL SURVIVAL IN PATIENTS WITH SARCOMA TREATED WITH DOXORUBICIN, OLARATUMAB AND DEXRAZOXANE: A REAL-WORLD EXPERIENCE IN DENMARK

Objective: Cardiotoxicity is a significant side effect of anthracycline-based chemotherapy. Dexrazoxane can reduce this risk, allowing for a higher cumulative dose and potentially improve overall survival (OS). This study examined the risk of cardiotoxicity and the OS in patients with soft tissue sarcoma (STS) treated with doxorubicin, olaratumab, and dexrazoxane.

Methods: A retrospective analysis was conducted including all patients with locally advanced or metastatic STS treated with doxorubicin, olaratumab, and dexrazoxane from 2015 to 2019 at Herlev University Hospital (HGH) and Århus University Hospital (AUH). Cardiotoxicity was evaluated using a multigated acquisition scan or echocardiography and defined as a decline in left ventricular ejection fraction (LVEF) by over 10 percentage points to below 50%. Early cardiotoxicity occurred within one year of doxorubicin initiation, while late occurred after one year. OS was measured from the start of doxorubicin to death from any cause.

Results: A total of 103 patients were included, 71 (69%) at HGH, 62 (60%) were males with a mean age of 58 years. The median cumulative dose of doxorubicin was 500 mg/m2 at HGH and 450 mg/m2 at AUH (p = 0.9). Dexrazoxane was administered in 86 (84%) patients, starting with the first cycle of doxorubicin at HGH and with the fourth cycle at AUH.
Cardiotoxicity was observed in 6 (8%) out of 71 patients at HGH and in 5 (16%) out of 32 patients at AUH (p = 0.3), with a median LVEF of 44%. All patients experienced early cardiotoxicity and were referred for a cardiac evaluation, which confirmed the decline in LVEF. Median OS was 19.6 months at HGH and 15 months at AUH (p = 0.3).

Conclusion: Administering dexrazoxane with doxorubicin in the first treatment cycle showed no statistically significant reduction in cardiotoxicity and improvement in OS. Further data from a larger retrospective study are pending.