AUTHOR=Ecker Nóra , Aranyi Marietta , Kiss Edina , Kiss Nóra , Lahm Erika , Nagy Zsófia , Sikter Márta , Szabó Ádám , Szentesi Anikó Szászné , Takács Klára , Uhlyarik Andrea , Vachaja József , Sebők Barbara , Pápai Zsuzsanna 

TITLE=Real-world experience with pazopanib in locally advanced and metastatic soft tissue sarcomas: a Hungarian retrospective single-center study

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 31 - 2025

YEAR=2025

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2025.1611965

DOI=10.3389/pore.2025.1611965

ISSN=1532-2807

ABSTRACT=Pazopanib is a tyrosine-kinase inhibitor also used for the treatment of advanced soft tissue sarcomas. In our retrospective study real-world data of stage 4 sarcoma patients treated in our department with pazopanib in the last 10 years were analyzed. Data were collected from the medical Medworks system used for daily work in our center. 99 patients were included: 46 male and 53 female. The median age at the diagnosis was 49.8 years. Most common histology subtypes were leiomyosarcoma and synovial sarcoma. All patients received 800 mg pazopanib per day that was decreased to 400 mg in case of toxicity. Treatment was continued until progression or unmanageable toxicity. Primary end point of the study was progression free survival, secondary endpoints were overall survival, overall response rate and disease control rate. The results in connection with demographic data, previous treatments, localizations of primary tumor and metastasis and, histological subtypes we analyzed.In our center pazopanib was most frequently used in third line. 61 patients received perioperative therapy; the most frequent regimen used in metastatic setting was VIP. Median PFS and OS were 3 months and 7 months. ORR was 14 percent and DCR was 40.45 percent. Dose reduction was necessary during the treatment of 56 patients. Hematological toxicity was detected in 23% of cases, most frequent events were thrombocytopenia grade 1 and leukocytopenia grade 2. Non-hematological adverse events were documented in half of the patients. Pazopanib was more effective in earlier lines of treatment. Compared to the phase 3 PALETTE trial more patients received perioperative therapy, median PFS and OS was shorter (3 months vs 4.6 months and 7 months vs 11.9 months) and ORR was higher (14% vs 9%) in our patient population. Dose reduction was more frequent in our center.Pazopanib is a therapeutic option for the treatment of advanced soft tissue sarcoma, even according to real-world data. Further investigations are needed to select patients who can benefit the most from pazopanib and to find the most appropriate sequence of therapy.