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KMID : 1146320230110010058
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Journal of Health Technology Assessment
2023 Volume.11 No. 1 p.58 ~ p.63
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Real-World Effectiveness of Pazopanib on Advanced Synovial Sarcoma: Meta-Analysis
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Han Ja-Young
Lee So-Young
Cho Eun
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Abstract
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Objectives: Synovial sarcoma (SS) is a histological subtype of soft tissue sarcoma (STS) with a high rate of metastasis and/or recurrence. Pazopanib is the only targeted therapy approved by FDA to treat advanced STS. To estimate the real-world effectiveness of pazopanib on advanced SS through a systematic literature review and meta-analysis.
Methods: Medline was searched from January 1, 2012 to December 31, 2020, with the keywords of pazopanib AND soft AND tissue AND sarcoma. The Preferred Reporting Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used. Observational studies in adults with advanced SS were included. Studies that did not report the histology-specific outcomes were excluded. Effectiveness outcomes included response rate (RR) (complete response [CR] and partial response [PR]) and clinical benefit (CR and PR plus stable disease [SD]). Considering the additional uncertainty associated with the effects of treatment, a random-effects model was performed using R version 4.1.1. Heterogeneity was assessed using the inconsistency index (I2 ). Sensitivity analysis was conducted with a broader definition of SD.
Results: Of 263 potentially relevant studies identified, seven observational studies were included in the meta-analysis. A total of 94 adult patients with advanced SS were included and the median sample size was 14. Three studies were conducted in South Korea and the remaining four studies were conducted in various countries. Five studies reported median progression-free survival in addition to tumor responses. The estimated RR of pazopanib was 16.4% (95% confidence interval [CI]: 0.05 to 0.28;2=60%) and 62.9% of patients showed clinical benefit (95% CI: 0.44 to 0.82; I2=74%).
Conclusion: Pazopanib controlled advanced SS as effectively as first-line chemotherapy. With increasing emphasis being given to understanding the histology-specific treatment effect, the present study adds important information to the existing literature on the treatment of advanced SS.
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KEYWORD
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Synovial sarcoma, Soft tissue sarcoma, Pazopanib, Meta-analysis, Systematic review
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