Poor Treatment Outcomes with Second-Line Chemotherapy in Advanced Synovial Sarcoma

Yuki Kojima, Tatsunori Shimoi, Takuji Seo, Shu Yazaki, Toshihiro Okuya, Yohei Ohtake, Hitomi S. Okuma, Akihiko Shimomura, Tadaaki Nishikawa, Maki Tanioka, Kazuki Sudo, Emi Noguchi, Kenji Tamura, Akihiko Yoshida, Shintaro Iwata, Eisuke Kobayashi, Akira Kawai, Yasuhiro Fujiwara, Kan Yonemori

Research output: Contribution to journalArticlepeer-review


Introduction: Synovial sarcoma (SS) predominantly affects adolescents and young adults. Doxorubicin with or without ifosfamide therapy is the standard first-line treatment for unresectable or metastatic SS. However, there is no standard second-line chemotherapy regimen. The purpose of the current study was to evaluate the outcomes of second-line chemotherapy for patients with SS. Methods: We retrospectively evaluated the outcomes of 61 patients with unresectable or metastatic SS who had received first-line chemotherapy at our institution between 1997 and 2017. Patients who received second-line chemotherapy were included in the analysis. Outcomes of the chemotherapy were evaluated. Results: Among the 61 patients treated with first-line chemotherapy, we identified 32 patients who received second-line chemotherapy. Most patients (62.5%) were under 40 years of age. Regarding second-line chemotherapy regimens, 6 (18.8%) patients were treated with doxorubicin with/without ifosfamide, 6 (18.8%) with ifosfamide and etoposide, 4 (12.5%) with docetaxel and gemcitabine, 5 (15.6%) with pazopanib, 2 (6.2%) with trabectedin, and 1 (3.1%) with eribulin. The overall response rate according to the Response Evaluation Criteria in Solid Tumors for all patients was 9.4%. Eleven patients (34.3%) achieved disease-control for >6 months. The median follow-up duration was 15.2 months. The 1-year progression-free and overall survival rates were 33.1% and 67.1%, respectively. Conclusion: Our exploratory study revealed that the response rate of second-line chemotherapy regimens for patients with SS was 9.4%. Therefore, there is an urgent need to develop more active therapeutic regimens for SSs.

Original languageEnglish
Pages (from-to)370-375
Number of pages6
JournalOncology (Switzerland)
Issue number7
Publication statusPublished - Jul 1 2022
Externally publishedYes


  • Chemotherapy
  • Outcome
  • Synovial sarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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