Newer medical therapies for metastatic soft tissue sarcoma (original) (raw)
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Metastatic soft tissue sarcoma: current treatment landscape and future perspectives
Expert Review of Anticancer Therapy, 2017
Introduction: The therapeutic armamentarium for advanced soft tissue sarcoma (STS) has increased over the last few years. Doxorubicin monotherapy or in combination is now the established first line treatment. Beyond first line treatment, no standard therapy has been established. Novel drugs have reached the lateclinical stage development demonstrating to be effective in controlled studies. While these novel treatments can be beneficial to a subset of patients, even producing long lasting remissions, a significant fraction of the STS population derives limited benefit. This is due to the fact that STS is a very heterogeneous disease with different histopathologic features, biological characteristics and clinical behaviour. Areas covered: The primary aim of this review is to summarize data from recent phase III clinical trials in unselected STS population, and to discuss their impact on the current clinical practice. Phase I-II trials of special interest are discussed as well. Expert commentary: Although our efforts in this research task are ongoing, the integration of biological therapies, the anti-angiogenesis targeted treatments as well as immunotherapy that may further improve the long term control of advanced STS are of special clinical interest. Clinical management of advanced STS should be tailored to each patient in order to optimize therapy.
Systemic therapy for advanced soft tissue sarcomas
Cancer, 2012
Soft tissue sarcomas (STS) are a rare, heterogeneous group of solid tumors in need of improved therapeutic options. First-line chemotherapy is considered the current standard of care for patients with advanced, symptomatic STS, but the median survival is only 8 to 12 months. Efforts to increase response rates by using combination or dose-dense regimens have largely failed to improve patient outcomes. However, increasing evidence supports the use of specific treatments for certain histological subtypes of STS, and novel therapies, including tyrosine kinase and mammalian target of rapamycin inhibitors, are currently under active investigation. In addition, novel treatment approaches (such as maintenance therapy) designed to prolong the duration of response to chemotherapy and delay disease progression are being explored. This article provides an overview of current systemic therapies for patients with advanced STS and discusses ongoing efforts designed to improve patient outcomes through the use of novel therapeutic agents and treatment strategies.
Molecular and Clinical Oncology, 2014
Soft tissue sarcomas (STS) are a group of rare mesenchymal cancers that include approximately 50 histological types and account for 1% of all adult cancers. The standard curative treatment option for localized disease is surgical resection and, if a surgically removed tumor exhibits high-risk characteristics, adjuvant chemotherapy and radiotherapy may be administered. Sarcoma presenting at an advanced stage has a dismal prognosis and survival has not markedly improved over the last 20 years. The standard first-line treatment for advanced STS, other than gastrointestinal stromal tumors, is cytotoxic chemotherapy. Therapies targeting pro-angiogenic factors have been a focus of drug development for STS over the last few years. Pazopanib, a multitargeted tyrosine kinase inhibitor, is a novel treatment option for patients with metastatic STS in the second-line setting. This is a presentation of 2 case reports of patients with metastatic STS who responded well to treatment with pazopanib.
Systematic Therapy for Unresectable or Metastatic Soft-Tissue Sarcomas: Past, Present, and Future
Current Oncology Reports, 2011
Unresectable or metastatic disease occurs in 40% to 60% of soft-tissue sarcoma (STS) patients and portends a poor prognosis. For decades, doxorubicin has formed the backbone of systemic treatment, with response rates of approximately 26%. Patients progressing following first-line therapy were left with few proven options. No other cytotoxic chemotherapy agent or combination has demonstrated superiority to doxorubicin. Advances in
Systemic therapy in soft tissue sarcomas: past, present and future
Indian journal of surgical oncology, 2011
Soft tissue sarcomas (STS) comprise 1% of all cancers diagnosed worldwide with more than 40 different histological subtypes each with distinct underlying biology, natural history and response to treatment. Due to the differential chemosensitivity it is imperative to have a correct histological diagnosis for optimal treatment of these patients. Even though surgery remains the primary modality of treatment there is increasing specialization of chemotherapy with respect to histological subtype. In general there is no place for "one size fits all strategy". To correctly define the role of chemotherapy, an extensive search was carried out online and offline for all relevant articles concerning chemotherapy in soft tissue sarcoma. This review aims to discuss the evolution of chemotherapy, its present role in neoadjuvant, adjuvant, metastatic settings and exciting trends with the advent of targeted therapies.
Advanced soft-tissue sarcoma and treatment options: critical appraisal of trabectedin
Cancer Management and Research, 2016
Soft-tissue sarcomas (STS) are a heterogeneous group of rare solid tumors of mesenchymal origin. This paper reviews the current status of systemic treatment in advanced and metastatic soft tissue sarcomas, with an emphasis on trabectedin. Trabectedin is a unique type of chemotherapeutic agent with multiple potential mechanisms of action. We discuss the putative mechanisms, as well as the toxicity and administration schedules of trabectedin, followed by its efficacy in first-line systemic therapy and beyond first-line systemic therapy.
Journal of Cancer Immunology & Therapy, 2018
Soft tissue sarcomas represent a rare but histologically variable type of solid malignancy. Doxorubicin based regimens either alone or in combination with other agents had remained unchanged for decades as the standard first line treatment for metastatic disease. The definition of metastatic disease has been changed with the introduction of the American Joint Commission on Cancer (AJCC) 8th edition guidelines. The overall survival for patients with metastatic disease, despite the approval of 2 new agents, had been in the region of 12-19 months. Olaratumab is a monoclonal antibody directed against PDGFR alpha. The results of a randomized phase 2 study comparing olaratumab plus doxorubicin with doxorubicin alone, showed a statistically significant improvement in progression free survival (PFS) up to 6 months, and a more dramatic improvement in overall survival (OS) to 26.9 months. This was the first randomized trial to show a significant improvement in overall survival compared to doxorubicin alone. Olaratumab has been granted accelerated approval by the Food and Drug Administration of the United States of America. Ongoing trials are underway to further demonstrate the mechanism of action and also to confirm the benefit in a Phase III study.