mGPS associated with survival in advanced soft tissue sarcoma patients receiving trabectedin treatment in retrospective analysis

BackgroundTrabectedin is a standard treatment for advanced soft tissue sarcomas (STS) after anthracycline failure. However, reliable prognostic markers remain limited. This study aims to evaluate the prognostic significance of inflammatory indices and the modified Glasgow Prognostic Score (mGPS) in STS patients treated with trabectedin.MethodsWe retrospectively analyzed 60 patients with advanced soft tissue sarcoma treated with trabectedin between 2015 and 2024 across multiple tertiary oncology centers. Baseline laboratory parameters obtained within two days prior to treatment initiation were used to calculate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), pan-immune-inflammation value (PIV), inflammatory burden index (IBI), prognostic nutritional index (PNI), and modified Glasgow Prognostic Score (mGPS). Associations with overall survival were evaluated using Cox proportional hazards regression. Skewed continuous variables were log-transformed prior to analysis. To reduce the risk of overfitting, a limited number of clinically relevant variables were included in the multivariate model, while potential collinearity among inflammatory indices was considered.ResultsA total of 37 patients (61.7%) were female, with a median age of 54.5 years (range: 35–77). Leiomyosarcoma was the predominant histological subtype, observed in 55% of cases. Trabectedin was administered at a median of the third-line setting (range: 2nd to 5th line). The objective response rate (ORR) was 24%, while the disease control rate (DCR) was 56%. The median follow-up duration was 10.2 months (range: 1–50.7). Median progression-free survival (PFS) was 4.9 months, and median overall survival (OS) was 11.7 months. Patients with mGPS 0 had significantly longer OS than those with mGPS 1 or 2 (median OS: 20.5 vs. 10.1 and 10.9 months; p = 0.006). In multivariate analysis, higher mGPS (1–2 vs 0) remained independently associated with worse OS (HR 3.9; 95% CI 1.5–10.0; p = 0.004).ConclusionIn this multicenter real-world cohort, mGPS was identified as an independent prognostic factor for overall survival in patients with advanced soft tissue sarcoma treated with trabectedin. These findings support its potential utility for prognostic stratification, warranting further prospective validation.