Publications by authors named "Patel Shreyaskumar"

Objective: We evaluated survival outcomes by primary tumor site in synovial sarcoma (SS) patients with localized and metastatic disease at diagnosis.

Methods: We conducted a retrospective review of 504 SS patients diagnosed from 1974 to 2020. Kaplan-Meier method, log-rank test, and Cox-proportional hazards regression were used.

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Rhabdomyosarcomas are the most common soft tissue sarcoma in children, and pediatric alveolar rhabdomyosarcoma (ARMS) prognosis has improved based on cooperative studies. However, in adults, ARMS is significantly rarer, has poorer outcomes, and currently lacks optimal treatment strategies. This study aimed to evaluate the clinical outcome of an adult ARMS population with different front-line systemic chemotherapies and determine if any chemotherapy regimen is associated with improved survival.

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Background: Undifferentiated pleomorphic sarcomas (UPSs) are amongst the most common subtypes of soft-tissue sarcomas. Few real-world data on the use of immune checkpoint blockade (ICB) in UPS patients and other high-grade pleomorphic STS patients are available.

Purpose: The purpose of our study is to describe the efficacy and toxicity of ICB in patients with advanced UPSs and other high-grade pleomorphic sarcomas treated at our institution.

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The vast majority of gastrointestinal stromal tumors (GISTs) are driven by activating mutations in , , or components of the succinate dehydrogenase (SDH) complex (, , , and genes). A small fraction of GISTs lack alterations in , , and . We aimed to further characterize the clinical and genomic characteristics of these so-called "triple-negative" GISTs.

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The role of systemic therapy in primary or advanced and metastatic chordoma has been traditionally limited because of the inherent resistance to cytotoxic therapies and lack of specific or effective therapeutic targets. Despite resection and adjuvant radiation therapy, local recurrence rates in clival chordoma remain high and the risk of systemic metastases is not trivial, leading to significant morbidity and mortality. Recently, molecular targeted therapies (MTTs) and immune checkpoint inhibitors (ICIs) have emerged as promising therapeutic avenues in chordoma.

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Article Synopsis
  • Targeting the DNA damage response (DDR) pathway could be a promising treatment strategy for leiomyosarcoma (LMS), with RNase H2 loss identified as a key alteration for potential therapies.
  • A study found that RNase H2 loss is significantly more prevalent in LMS (11.5%) compared to other tumors (3.8%), particularly in uterine LMS (21%) and soft-tissue LMS (30%).
  • Although RNase H2 loss and homozygous deletions of RNASEH2B exist in LMS, they did not correlate with significant differences in overall survival among U-LMS patients, but the accuracy of RNase H2 testing suggests its potential use in future clinical trials targeting DDR.
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Ripretinib and avapritinib have demonstrated activity in the late-line treatment of gastrointestinal stomal tumors (GISTs). We investigated whether patients previously treated with ripretinib benefit from avapritinib, and vice versa. Patients diagnosed with metastatic/unresectable GIST and treated with both drugs at two institutions in 2000-2021 were included.

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  • A randomized phase 2 trial was conducted to evaluate the effectiveness of neoadjuvant immune checkpoint blockade (ICB) therapies (nivolumab and nivolumab/ipilimumab) in patients with resectable retroperitoneal DDLPS and extremity/truncal UPS.
  • The primary endpoint of pathologic response showed a median hyalinization of 8.8% in DDLPS and 89% in UPS, with secondary endpoints focusing on immune changes and survival rates over time.
  • Results indicated that lower pre-treatment regulatory T cell densities correlated with better pathological outcomes, and that neoadjuvant ICB led to significant immune changes and benefits, particularly in patients with UPS when combined with radiation therapy
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Purpose: Chondrosarcomas are the most common primary bone tumor in adults. Isocitrate dehydrogenase 1 (IDH1) and IDH2 mutations are prevalent. We aimed to assess the clinico-genomic properties of IDH mutant versus IDH wild-type (WT) chondrosarcomas as well as alterations in other genes.

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Purpose: Developing new therapeutics for any of the more than 100 sarcoma subtypes presents a challenge. After progression from standard therapies, patients with sarcoma may be referred for enrollment in early-phase trials. This study aimed to investigate whether enrollment in biomarker-matched early-phase clinical trials leads to better outcomes for patients with advanced sarcoma.

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  • Tenosynovial giant cell tumour (TGCT) is a rare tumor that grows around joints and tendons, with two types: nodular (less aggressive) and diffuse (more aggressive).
  • TGCT can lead to chronic pain and negatively affect a person's quality of life, though it's not usually life-threatening.
  • A global meeting in June 2022 brought together experts and patients to establish better treatment guidelines for TGCT, given the challenges in making consistent treatment choices worldwide.
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  • Undifferentiated pleomorphic sarcoma (UPS) shows significant immune infiltration, with immune checkpoint inhibitors benefiting around 20% of patients, leading to an investigation of the tumor's immune microenvironment and its impact on patient outcomes.
  • Researchers performed immunohistochemistry on 105 surgically removed UPS samples, assessing various immune markers and correlations related to overall and disease-free survival using statistical methods.
  • Key findings revealed that certain immune markers (like CD39 and CD73) were linked to treatment responsiveness and survival rates, with significant variations seen in primary vs. recurrent and metastatic tumors, highlighting the complexity of immune interactions in UPS.
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Purpose: Alveolar soft part sarcoma (ASPS) is a rare, highly vascular tumor with few treatment options. We designed a phase II randomized trial to determine the activity and tolerability of single-agent cediranib or sunitinib in patients with advanced metastatic ASPS.

Patients And Methods: Patients 16 years of age and older were randomized to receive cediranib (30 mg) or sunitinib (37.

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  • - The Connective Tissue Oncology Society established guidelines for identifying ultrarare sarcomas (URS), which occur in fewer than 1 in 1,000,000 people; a study analyzed 56 patients with soft tissue sarcomas and 21 with bone sarcomas from Phase 1 trials.
  • - Out of 587 sarcoma cases, 18.1% were URS, predominantly affecting males with a median age of 44.3, and they showed a higher objective response rate to treatment (13.2%) compared to common sarcomas (6.9%).
  • - The study highlights that matched trials based on genomic profiling resulted in better outcomes, with a median overall survival of 27.
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Objective: Well-differentiated (WDLPS) and dedifferentiated liposarcoma (DDLPS) account for the majority of liposarcomas. Although gemcitabine-docetaxel is used as second-line treatment in soft tissue sarcomas, its efficacy in WDLPS/DDLPS is not established. This study retrospectively analyzed the efficacy of gemcitabine regimens in WDLPS/DDLPS.

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The aim of this study is to evaluate the outcomes and tolerance of immune checkpoint inhibitors (ICIs) for patients with recurrent chordoma. We reviewed the records of 17 patients with recurrent chordomas who received ICIs for progressing disease as part of their treatment between 2016 and 2020. Response was assessed using response evaluation criteria in solid tumors 1.

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Background: Few standard treatment options are available for patients with metastatic sarcomas. We did this trial to evaluate the efficacy, safety, and changes in the tumour microenvironment for durvalumab, an anti-PD-L1 drug, and tremelimumab, an anti-CTLA-4 drug, across multiple sarcoma subtypes.

Methods: In this single-centre phase 2 trial, done at The University of Texas MD Anderson Cancer Center (Houston, TX USA), patients aged 18 years or older with advanced or metastatic sarcoma with an Eastern Cooperative Oncology Group performance status of 0 or 1 who had received at least one previous line of systemic therapy were enrolled in disease subtype-specific groups (liposarcoma, leiomyosarcoma, angiosarcoma, undifferentiated pleomorphic sarcoma, synovial sarcoma, osteosarcoma, alveolar soft-part sarcoma, chordoma, and other sarcomas).

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Background: Systemic treatments for angiosarcoma remains an area of unmet clinical need. The authors conducted this retrospective study to assess the clinical activity of checkpoint inhibitors in patients with angiosarcoma. The primary objective was to assess the objective response rate, and the secondary objective was to assess the progression-free and overall survival durations and disease control rate.

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PD-1 blockade (nivolumab) efficacy remains modest for metastatic sarcoma. In this paper, we present an open-label, non-randomized, non-comparative pilot study of bempegaldesleukin, a CD122-preferential interleukin-2 pathway agonist, with nivolumab in refractory sarcoma at Memorial Sloan Kettering/MD Anderson Cancer Centers (NCT03282344). We report on the primary outcome of objective response rate (ORR) and secondary endpoints of toxicity, clinical benefit, progression-free survival, overall survival, and durations of response/treatment.

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Purpose: We evaluated a cohort of patients with cardiac angiosarcomas (CA) who developed brain metastases (BM) to define outcomes and intracranial hemorrhage (IH) risk.

Methods: We reviewed 26 consecutive patients with BM treated between 1988 and 2020 identified from a departmental CA (n=103) database. Causes of death were recorded, and a terminal hemorrhage (TH) was defined as an IH that caused death or prompted a transfer to hospice.

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Purpose: Determine whether specific CTNNB1 or APC mutations in patients with desmoid tumor were associated with differences in clinical responses to systemic treatments.

Experimental Design: We established a multi-institutional dataset of previously treated patients with desmoid tumor across four U.S.

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ARST1321, a trial of patients with advanced soft tissue sarcoma, was the first National Clinical Trials Network study codeveloped by pediatric and adult consortia with two treatment cohorts. We report on the findings of a survey to identify barriers to enrolling adolescent and young adult patients (15-39 years) onto the nonchemotherapy arm. The survey response rate was 31% with a 70% completion rate.

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Purpose: Primary or secondary mutations in or platelet-derived growth factor receptor alpha () underlie tyrosine kinase inhibitor resistance in most GI stromal tumors (GISTs). Avapritinib selectively and potently inhibits KIT- and PDGFRA-mutant kinases. In the phase I NAVIGATOR study (NCT02508532), avapritinib showed clinical activity against PDGFRA D842V-mutant and later-line KIT-mutant GIST.

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