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Soft Tissue Tumors

(P 352) TIME TOXICITY AND EFFECT OF CHEMOTHERAPY FOR PATIENTS WITH METASTATIC SOFT TISSUE SARCOMA - A RETROSPECTIVE REAL-WORLD STUDY OF 244 PATIENTS

    Author(s)

  • Morten Nielsen, MD PhD

    Resident
    National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
    Copenhagen, Hovedstaden, Denmark

    • Co-Author(s)

  • Niels Junker, MD, PhD

    Chief Physician
    Department of Oncology, Herlev University Hospital
    Herlev, Hovedstaden, Denmark

Objective: Patients with metastatic soft tissue sarcoma (STS) often undergo multiple lines of chemotherapy. These treatments are associated with toxicity, not only due to adverse effects, but also in terms of time spent in hospital—so-called time toxicity. In this study, we analyzed overall survival, treatment efficacy, and hospital time burden in a cohort of patients with metastatic STS receiving one or more lines of chemotherapy.

Methods: We included all patients diagnosed with STS (ICD-10/ICD-11) who received at least one dose of doxorubicin as first-line therapy between 2017 and 2023 at the Department of Oncology, Herlev Hospital, Denmark. Clinical data were extracted from electronic health records (Sundhedsplatformen, Epic). Statistical analyses were performed using RStudio (version 2024.12.1). Time to next treatment (TTNT) was used as a proxy for progression free survival. Time spend in hospital was defined as the number of days with at least one hospital contact (including outpatient visits, treatments, scans, blood draws, etc.) and expressed as a proportion of the patient’s remaining lifetime.

Results: A total of 244 patients were included. Of these, 153 received doxorubicin with dexrazoxane, 47 received doxorubicin with olaratumab, and 44 received doxorubicin monotherapy. Median overall survival (OS) for the entire cohort was 21.7 months, with no statistically significant difference between treatment subgroups. Patients with leiomyosarcoma had the longest median OS at 32.2 months. TTNT following first-line doxorubicin was 5.4 months, while TTNT for subsequent lines ranged from 3.8 to 4.7 months. Median time spend in hospital was 20.3% out of the patients’ remaining lifetime.

Conclusion: This study provides novel and comprehensive data on survival outcomes and treatment efficacy in patients with metastatic STS. Importantly, our findings underscore that a substantial proportion of patients’ remaining lifespan is spent attending hospital, emphasizing the need to consider time toxicity in treatment decisions and shared clinical decision-making.