Correlation between overall survival and growth modulation index in pre-treated sarcoma patients: a study from the French Sarcoma Group

• Published in: Annals of oncology Vol. 24; no. 10; pp. 2681 - 2685
• Main Authors: Cousin, S., Blay, J.Y., Bertucci, F., Isambert, N., Italiano, A., Bompas, E., Ray-Coquard, I., Perrot, D., Chaix, M., Bui-Nguyen, B., Chaigneau, L., Corradini, N., Penel, N.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.10.2013; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic - therapeutic use; Antineoplastic agents; Biological and medical sciences; Child; Child, Preschool; Dermatology; Disease Progression; Disease-Free Survival; Doxorubicin - therapeutic use; end point; Female; growth modulation index; Humans; Infant; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Pharmacology. Drug treatments; Retrospective Studies; Sarcoma - drug therapy; Sarcoma - mortality; Soft Tissue Neoplasms - drug therapy; Soft Tissue Neoplasms - mortality; soft tissue sarcoma; Survival; Survival Rate; time to progression; Treatment Outcome; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; Young Adult; France; Europe; growth modulation index; end point; time to progression; soft tissue sarcoma; Human; Correlation; Growth; Soft tissue sarcoma; Index; Malignant tumor; Survival; Treatment; Modulation; Cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdt278

Growth modulation index (GMI), the ratio of two times to progression measured in patients receiving two successive treatments (GMI = TTP2/TTP1), has been proposed as a criterion of phase II clinical trials. Nevertheless, its use has been limited until now. We carried out a retrospective multicentre study in soft tissue sarcoma patients receiving a second-line treatment after doxorubicin-based regimens to evaluate the link between overall survival and GMI. Second-line treatments were classified as ‘active’ according to the EORTC-STBSG criteria (3-month progression-free rate >40% or 6-month PFR >14%). Comparisons used chi-squared and log-rank tests. The population consisted in 106 men and 121 women, 110 patients (48%) received ‘active drugs’. Median OS from the second-line start was 317 days. Sixty-nine patients experienced GMI >1.33 (30.4%). Treatments with ‘active drug’ were not associated with OS improvement: 490 versus 407 days (P = 0.524). Median OS was highly correlated with GMI: 324, 302 and 710 days with GMI <1, GMI = [1.00–1.33], and GMI >1.33, respectively (P < 0.0001). In logistic regression analysis, the sole predictive factor was the number of doxorubicin-based chemotherapy cycles. GMI seems to be an interesting end point that provides additional information compared with classical criteria. GMI >1.33 is associated with significant OS improvement.