Use of doxorubicin and trabectedin in low-grade endometrial stromal sarcoma: A case report

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Background: Low-grade endometrial stromal sarcoma (LG-ESS) is the most common type of endometrial stromal malignancy, yet treatment options are limited, particularly in advanced or recurrent cases that are resistant to hormonal therapy. Case Presentation: We describe a 48-year-old patient with recurrent stage IVB LG-ESS who was treated with a combination of doxorubicin and trabectedin, followed by trabectedin maintenance; a protocol extrapolated from leiomyosarcoma treatment. Following failure to hormonal therapy, this regimen demonstrated disease stabilization, particularly in pelvic metastases. Conclusion: Our results highlight the potential role of this chemotherapy combination in hormonal therapy-resistant LG-ESS, a malignancy with limited systemic therapeutic options. This is the first reported case of LG-ESS achieving prolonged stable disease with doxorubicin-trabectedin therapy and trabectedin maintenance. Given the manageable toxicity profile and encouraging tumor control, further studies should explore its potential role in LG-ESS management.

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