PMC6629888_01
The CT scan of this patient showed lung metastases from synovial sarcoma at the baseline in February 2015 (A). At the first radiological evaluation in April 2015 there was a partial response (B). The patient was on drug holiday from June 2016 to April 2018 when the same lesion started to grow again (C). It then showed a good response to Trabectedin re-challenge in July 2018 (D).
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F1
Ifosfamide was administered for a total of six cycles. During follow-up, in February 2015, the CT scan showed almost 15 nodules in the lung ranging from 5 to 10 mm (Figure 1A). In the same month the patient started therapy with The first radiological evaluation in April 2015 showed a dimensional reduction of all the lung nodules (Figure 1B). The patient continued the therapy, and in July and October 2015 the CT scan confirmed the partial response of the lung lesions. However, 6 months later, in March 2018 the radiologic findings showed disease progression with multiple, new lung metastases (Figure 1C). The subsequent radiological evaluations in July and October 2018 showed stable disease with signs of response in some nodules (Figure 1D). The patient is continuing Trabectedin, without new significant adverse events.
PMC6629888_02
Lung metastases from uterine leiomyosarcoma right before starting Trabectedin in November 2015 (A) showing an almost complete response after treatment in February 2016 (B). Systemic therapy was then suspended for a drug holiday. During this period the lesion began to grow again in December 2017 (C). However, in March 2018 after Trabectedin re-challenge a new partial response was observed (D).
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F2
In November 2015 a new lung and soft tissue (gluteus muscle) progression occurred (Figure 2A). In February 2016 the CT scan documented a partial response (Figure 2B), which was maintained until November 2016 when, according to patient's desire, a drug holiday was started. In July 2017 the CT scan showed a significant dimensional increase of a single lung nodule (Figure 2C). Therefore, she re-started Trabectedin with prophylactic G-CSFs and after four cycles, in March 2018, the CT scan documented a partial response (Figure 2D).
This patient showed hypervascular liver metastases from retroperitoneal leiomyosarcoma at the baseline CT scan in April 2015 (A). The lesions were reduced in both size and vascularisation after treatment with Trabectedin, which was stopped in December 2016 (B) for a drug holiday.
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F3
The CT scan in August 2015 showed the appearance of new hepatic lesions (Figure 3A). The response was then maintained until December 2016 (Figure 3B), when a therapeutic holiday was proposed to the patient after a total of 22 cycles of Trabectedin.
PMC6629888_03
This patient experienced in June 2016 disease progression with multiple peritoneal lesions at MRI (A) after being treated with Trabectedin and surgery. However, Trabectedin showed to be effective again, achieving a partial response in February 2018 (B).
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F4
A CT scan showed a new abdominal progression in June 2016 (Figure 4A) with the appearance of multiple peritoneal lesions. After 18 months of therapy and a new partial response in some of the abdominal nodules (Figure 4B), we proposed a new drug holiday in February 2018.