Neoadjuvant pazopanib in nonrhabdomyosarcoma soft tissue sarcomas (ARST1321): A report of major wound complications from the Children's Oncology Group and NRG Oncology

Mark L. Kayton, Aaron R. Weiss, Wei Xue, Odion Binitie, Andrea Hayes Dixon, R. Lor Randall, Joel I. Sorger, Douglas S. Hawkins, Sheri L. Spunt, Dian Wang, Lynn Million, Stephanie Terezakis, Edwin Choy, Scott H. Okuno, Rajkumar Venkatramani, Yen Lin Chen, Thomas J. Scharschmidt

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background and Objectives: The impact upon wound healing of targeted molecular therapies, when incorporated into neoadjuvant therapy of soft tissue sarcoma, is largely unknown. Here, we describe wound complications following addition of pazopanib, a tyrosine kinase inhibitor (TKI), to neoadjuvant radiotherapy (RT) +/− chemotherapy for soft tissue sarcoma. Methods: Wound complications were evaluated on dose-finding and randomized arms of ARST1321, a phase II/III study incorporating neoadjuvant RT, +/− pazopanib, +/− ifosfamide/doxorubicin (ID) for sarcoma therapy. Results: Of 85 evaluable patients, 35 (41%) experienced postoperative wound complications. Most (57%) were grade III. Randomization to pazopanib + RT + ID carried a 50% wound complication rate (17/34, with 47% grade III), compared to 22% (5/23) with ID + RT alone. In nonchemotherapy study arms, pazopanib + RT resulted in a 59% wound complication rate versus 25% for those receiving RT alone. Grade III wound complications occurred among 26% (15/58) of all patients receiving pazopanib. Wound complications occurred a median of 35 days postoperatively. Some occurred following diagnostic biopsies and at remote surgical sites. Conclusion: The addition of pazopanib to neoadjuvant chemotherapy and RT resulted in a higher wound complication rate following therapy of soft tissue sarcoma. The rate of grade III complications remained comparable to that reported in contemporary literature.

Original languageEnglish (US)
Pages (from-to)871-881
Number of pages11
JournalJournal of Surgical Oncology
Volume127
Issue number5
DOIs
StatePublished - Apr 2023

Bibliographical note

Funding Information:
The authors acknowledge the contributions of Robin Arens, AAS, Clinical Research Associate; and of Research Coordinators Justin Davis and Ellen Tsan, MPH. This study was funded by National Clinical Trials Network Operations Center Grant U10CA180886, National Clinical Trials Network Statistics & Data Center Grant U10CA180899, National Cancer Institute IROC Operations Grant CA180803, St. Baldrick's Foundation and Seattle Children's Foundation, from Kat's Crew Guild through the Sarcoma Research Fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
The authors acknowledge the contributions of Robin Arens, AAS, Clinical Research Associate; and of Research Coordinators Justin Davis and Ellen Tsan, MPH. This study was funded by National Clinical Trials Network Operations Center Grant U10CA180886, National Clinical Trials Network Statistics & Data Center Grant U10CA180899, National Cancer Institute IROC Operations Grant CA180803, St. Baldrick's Foundation and Seattle Children's Foundation, from Kat's Crew Guild through the Sarcoma Research Fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2023 Wiley Periodicals LLC.

Keywords

  • neoadjuvant
  • pazopanib
  • sarcoma
  • wound complications
  • wound healing

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