Hey, it didn’t not work.
Top Line: Even stage I uterine leiomyosarcoma is bad, so may it needs adjuvant chemo.
The Study: When it comes to stage I disease, the only randomized trial on this topic showed that adjuvant pelvic radiation doesn’t improve survival compared to observation alone—likely as a result of high rates of distant relapse. So...let's try chemo. GOG 277 was designed to determine if adjuvant gemcitabine and docetaxel followed by doxorubicin would improve survival compared to the gold standard of observation. The trial had good intentions, but unfortunately the desire to enroll patients on GOG 277 was even rarer than the disease itself. As a result, only 38 patients were enrolled between 2012 and 2016. While we obviously can’t draw any meaningful conclusions from this cohort, it’s worth at least noting there were no glaring differences in survival or patterns of failure. The authors don't speculate much about reasons for low enrollment so it’s unclear if the general bias against randomization was towards observation or chemo. So, we’re left where we started: with no data to support either adjuvant radiation or chemotherapy.
Bottom Line: There’s still no defined role for adjuvant chemotherapy for stage I uterine leiomyosarcoma due to pitiful trial accrual. | Hensley, J Clin Oncol 2018
The Study: When it comes to stage I disease, the only randomized trial on this topic showed that adjuvant pelvic radiation doesn’t improve survival compared to observation alone—likely as a result of high rates of distant relapse. So...let's try chemo. GOG 277 was designed to determine if adjuvant gemcitabine and docetaxel followed by doxorubicin would improve survival compared to the gold standard of observation. The trial had good intentions, but unfortunately the desire to enroll patients on GOG 277 was even rarer than the disease itself. As a result, only 38 patients were enrolled between 2012 and 2016. While we obviously can’t draw any meaningful conclusions from this cohort, it’s worth at least noting there were no glaring differences in survival or patterns of failure. The authors don't speculate much about reasons for low enrollment so it’s unclear if the general bias against randomization was towards observation or chemo. So, we’re left where we started: with no data to support either adjuvant radiation or chemotherapy.
Bottom Line: There’s still no defined role for adjuvant chemotherapy for stage I uterine leiomyosarcoma due to pitiful trial accrual. | Hensley, J Clin Oncol 2018
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