Browsing by Author "Akin, Imge"

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    Efficacy and Safety of Doxorubicin-Ifosfamide Versus Gemcitabine-Docetaxel as First-Line Therapy in Advanced Nonuterine Leiomyosarcoma: A Multicenter Real-World Study
    (Wiley, 2025) Tunbekici, Salih; Sahin, Gokhan; Yuksel, Haydar Cagatay; Acar, Caner; Akin, Imge; Aslanhan, Hasan; Gursoy, Pinar
    Nonuterine leiomyosarcoma (NU-LMS) is a rare and biologically distinct subtype of soft tissue sarcoma (STS) with clinical behavior differing from that of uterine leiomyosarcoma. In advanced or metastatic STS, immunotherapy has demonstrated only modest activity, and chemotherapy remains the cornerstone of treatment. However, there is a persistent unmet need for more effective and better-tolerated options in this population. This multicenter, retrospective study included 150 patients with histologically confirmed metastatic NU-LMS who received first-line doxorubicin-ifosfamide (AI) or gemcitabine-docetaxel (GD) at 26 oncology centers in Turkey between 2010 and 2024. The primary endpoint was overall survival (OS). Survival was analyzed using Kaplan-Meier estimates and Cox proportional hazards models. Of 150 patients, 79 received AI and 71 received GD. Median OS for the entire cohort was 21.0 months. Median OS was 22.0 months with AI and 19.1 months with GD (p = .18), median progression-free survival was 7.3 versus 6.1 months (p = .66), and overall response rate was 25.3% versus 29.6% (p = .58), indicating no statistically significant differences in efficacy between the two regimens. Hematologic toxicities were less frequent with GD. AI and GD demonstrated comparable efficacy as first-line regimens for advanced or metastatic NU-LMS, with fewer hematologic toxicities observed for GD. Tumor location may have prognostic implications. These findings support individualized treatment selection and highlight the need for prospective studies in this rare and understudied sarcoma subtype, while the recent LMS-04 trial underscores the importance of future comparisons with doxorubicin-trabectedin to further refine first-line strategies in LMS.
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    Article
    Real-World Comparison of Doxorubicin-Ifosfamide Versus Gemcitabine-Docetaxel Regimens in Metastatic Uterine Leiomyosarcoma: A Multicenter Retrospective Study
    (Springer, 2025) Tunbekici, Salih; Sahin, Gokhan; Yuksel, Haydar Cagatay; Acar, Caner; Akin, Imge; Aslanhan, Hasan; Goker, Erdem
    BackgroundUterine leiomyosarcoma is a rare and aggressive malignancy with limited responsiveness to standard therapies. We conducted a real-world, multicenter study to compare the clinical efficacy and safety of two commonly used first-line chemotherapy regimens-doxorubicin-ifosfamide and gemcitabine-docetaxel-in patients with metastatic uterine leiomyosarcoma.MethodsThis retrospective cohort included 271 patients with advanced or metastatic uterine leiomyosarcoma treated between 2010 and 2023 across 30 centers in Turkey. Patients received either doxorubicin-ifosfamide (n = 142) or gemcitabine-docetaxel (n = 129) as first-line therapy. The primary endpoint was overall survival; secondary endpoints included progression-free survival, objective response rate, disease control rate, and safety. Adverse events were graded according to the Common Terminology Criteria for Adverse Events version 5.0, while survival outcomes were estimated using the Kaplan-Meier method and further analyzed with Cox proportional hazards models.ResultsMedian overall survival was 19.7 months with doxorubicin-ifosfamide and 20.2 months with gemcitabine-docetaxel (P = .26). Median progression-free survival was 5.5 months with doxorubicin-ifosfamide and 7.0 months with gemcitabine-docetaxel (P = .62). The objective response rate was numerically higher with gemcitabine-docetaxel (35% vs. 26%), although not statistically significant (P = .11). Grade 3-4 neutropenia (16% vs. 12%) and febrile neutropenia (7% vs. 6%) were more frequent with doxorubicin-ifosfamide.ConclusionsIn this largest-to-date real-world cohort of metastatic uterine leiomyosarcoma, doxorubicin-ifosfamide and gemcitabine-docetaxel demonstrated comparable survival outcomes. Gemcitabine-docetaxel, however, was associated with a more favorable hematologic safety profile. These findings support the clinical utility of both regimens while underscoring the need for prospective, biomarker-driven studies to refine treatment selection and improve personalization in this rare malignancy.