Retrospective audit of doxorubicin in advanced soft tissue sarcoma in the West of Scotland

Background: Single-agent doxorubicin represents first line treatment for locally advanced or metastatic soft tissue sarcoma. There has been limited improvement in patient outcomes in this group. Despite promising initial results of combination doxorubicin with olaratumab, an anti-platelet-derived growth factor receptor antibody, the phase three results have not demonstrated a survival benefit. Aims: This audit aims to collect data on the efficacy and toxicities of first line single-agent doxorubicin for patients with advanced sarcoma in the WoS. It was intended as a comparator for combination doxorubicin and olaratumab, however this has been discontinued. Methods Patients were identified from Chemocare (electronic chemotherapy prescription). Electronic medical records were reviewed to collect the relevant data points. An online calculator was used for the Charlson Co-morbidity Index (CCI) and analysis was performed using GraphPad Prism. Results: 64 patients were identified over seven years. The most common site was limb (35.9%) and the most common type was leiomyosarcoma (25%). 25% of patients had a CCI ≥3 and most patients were performance status (PS) 1. The majority of patients (85.9%) had metastatic disease. Median time to best response was 55.5 days. Median overall survival was 15.4 months and median time to disease progression was 4.7 months. Regarding toxicity, 18.8% required a dose reduction and 32.8% had a dose delay. Conclusion/Discussion Overall: outcomes for patients with advanced soft tissue sarcoma remain poor. The results from this audit are similar to those previously published. This is despite patients having an increased number of co-morbidities, lower PS and increased age. Project completed as part of the National Sarcoma Awareness Fellowship 2018