scholarly journals Precision Medicine in Soft Tissue Sarcoma Treatment

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 221 ◽  
Author(s):  
Kenji Nakano ◽  
Shunji Takahashi
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Targeted Therapies ◽  
Antitumor Agents ◽  
Treatment Strategies ◽  
Genetic Mutation ◽  
Histological Subtypes ◽  
Genome Profiling ◽  
Number Of Patients ◽  
Precision Therapy

Soft tissue sarcoma (STS) is a rare component of malignant diseases. STS includes various histological subtypes, and there are some important differences among the different histological subtypes regarding the mutation profile and sensitivity to antitumor agents. Many clinical trials of STS incorporating many different histological subtypes in various populations have been conducted; it is difficult to compare the findings and make conclusions about clinical efficacy. Targeted therapies focusing on specific histological subtypes and precision therapy focusing on the specific genetic mutation(s) of each STS patient are being investigated. Since STS patients are a small population, new clinical trial designs are required to evaluate and establish new targeted therapies for each histological subtype that has a limited number of patients, and preclinical investigations are needed to detect targetable mutations. Now that cancer genome profiling is used in clinical practice, it is urgently necessary to connect the genome profiling data obtained in clinical settings to the optimal clinical treatment strategies. Herein we review the development and challenges of precision therapy in the management of STS patients.

scholarly journals The PTEN Tumor Suppressor Gene in Soft Tissue Sarcoma

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1169 ◽  
Author(s):  
Sioletic Stefano ◽  
Scambia Giovanni
Keyword(s):  
Soft Tissue ◽  
Tumor Suppressor ◽  
Soft Tissue Sarcoma ◽  
Biological Significance ◽  
Treatment Strategies ◽  
Predictive Biomarkers ◽  
Suppressor Gene ◽  
Oncogenic Signaling ◽  
Tensin Homolog ◽  
Pathologic Features

Soft tissue sarcoma (STS) is a rare malignancy of mesenchymal origin classified into more than 50 different subtypes with distinct clinical and pathologic features. Despite the poor prognosis in the majority of patients, only modest improvements in treatment strategies have been achieved, largely due to the rarity and heterogeneity of these tumors. Therefore, the discovery of new prognostic and predictive biomarkers, together with new therapeutic targets, is of enormous interest. Phosphatase and tensin homolog (PTEN) is a well-known tumor suppressor that commonly loses its function via mutation, deletion, transcriptional silencing, or protein instability, and is frequently downregulated in distinct sarcoma subtypes. The loss of PTEN function has consequent alterations in important pathways implicated in cell proliferation, survival, migration, and genomic stability. PTEN can also interact with other tumor suppressors and oncogenic signaling pathways that have important implications for the pathogenesis in certain STSs. The aim of the present review is to summarize the biological significance of PTEN in STS and its potential role in the development of new therapeutic strategies.

Soft Tissue Sarcoma – a Current Review of the Diagnostic and Treatment Strategies

2019 ◽  
Vol 157 (06) ◽  
pp. 644-653 ◽  
Author(s):  
Sebastian Scheidt ◽  
Cornelius Jacobs ◽  
Sebastian Koob ◽  
Kristian Welle ◽  
Sebastian Walter ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Soft Tissue Sarcomas ◽  
Current Evidence ◽  
Delayed Treatment ◽  
Current Review ◽  
Soft Tissue Swelling ◽  
A Current

AbstractSoft tissue sarcomas are a heterogeneous group of neoplasias that due to their often clinically silent appearance often remain undetected or experience delayed treatment. Especially soft tissue swelling is often misinterpreted by patients and doctors and trivialized or verified with an incorrect biopsy technique. The hereby evoked complications for the patients are serious and may be reduced by simply following the available guidelines. The treatment of soft tissue sarcomas requires a close interdisciplinary coordination between specialists in tumor orthopedics, oncology, radiology, pathology and radiotherapy. On the basis of a selective literature review, the following article points out the current evidence on the treatment and illustrates a treatment algorithm.

Novel treatment strategies for soft tissue sarcoma

2007 ◽  
Vol 62 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Bernd Kasper ◽  
Thierry Gil ◽  
Veronique D’Hondt ◽  
Michael Gebhart ◽  
Ahmad Awada
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Treatment Strategies ◽  
Novel Treatment ◽  
Novel Treatment Strategies

scholarly journals Preoperative Factors Associated with Infiltrative Histologic Growth Patterns in Extremity Soft Tissue Sarcoma

Sarcoma ◽  
2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Jong Woong Park ◽  
Han-Soo Kim ◽  
Cheol Lee ◽  
Hye Jin Yoo ◽  
Ji Yeon Yun ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Growth Pattern ◽  
Treatment Strategies ◽  
Preoperative Assessment ◽  
Growth Patterns ◽  
Surrounding Tissue ◽  
Mri Findings ◽  
Predictive Index ◽  
Factors Associated

Soft tissue sarcoma (STS) with an infiltrative histologic growth pattern, when compared to STS with an expansile pattern, may pose difficulties in local control. Preoperative assessment of the presence of infiltrative histologic growth pattern would be helpful in deciding treatment strategies. A review of 144 patients who underwent surgery for extremity STS was performed. Microscopically, the histologic growth pattern was defined as infiltrative if the penetration of the tumor cells into the surrounding tissue was observed. Possible clinicopathologic factors that might be associated with infiltrative histologic growth pattern were investigated with regard to patient demographics, tumor characteristics, and MRI findings. Of the 144 tumors, 71 (49%) showed infiltrative histologic growth pattern. On multivariate analysis, histological subtypes other than liposarcoma (OR = 4.57, p=0.02) and infiltrative border on MRI (OR = 2.48, p=0.01) were independent factors associated with infiltrative histologic growth pattern. Predictive index based on these two factors showed a significant improved accuracy (ROC-AUC = 0.647) for predicting infiltrative histologic growth pattern compared to either factor alone. Our data suggests that liposarcoma histology and tumor border on MRI can predict histologic growth pattern in extremity STS.

scholarly journals The clinical efficacy of eribulin to soft tissue sarcoma patients: differences in histological subtypes

2019 ◽  
Vol 30 ◽  
pp. vi123-vi124
Author(s):  
Kenji Nakano ◽  
Yuki Funauchi ◽  
Keiko Hayakawa ◽  
Taisuke Tanizawa ◽  
Keisuke Ae ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Clinical Efficacy ◽  
Histological Subtypes

scholarly journals Comparison of health-related quality of life with different antitumor agents for advanced soft tissue sarcoma

2020 ◽  
Author(s):  
Kayo Suzuki ◽  
Taketoshi Yasuda ◽  
Kenta Watanabe ◽  
Masahiko Kanamori ◽  
Yoshiharu Kawaguchi
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Global Health ◽  
Antitumor Agents ◽  
Second Line ◽  
Advanced Soft Tissue Sarcoma ◽  
Health Related

Abstract Background During cancer treatment, maintenance and improvement of quality of life (QOL) are important, as is prolongation of overall survival. As the disease progresses, patients may experience a decline in QOL due to physical or mental changes. However, few studies have evaluated QOL longitudinally in advanced soft tissue sarcoma (STS) patients according to the antitumor agent. The purpose of this study was to compare health-related QOL (HRQOL) in patients with advanced STS receiving the combination regimen of doxorubicin and ifosfamide (AI) or three novel antitumor agents (pazopanib, trabectedin, eribulin). Methods Twelve patients diagnosed with advanced STS who started chemotherapy between 2010 and 2017 at our hospital were enrolled. HRQOL was assessed using the European Organization on Research and Treatment of Cancer Quality-of-Life Core Questionnaire-30 (EORTC QLQ-C30) after three cycles of chemotherapy before assessing the effect of treatment. Global health status, a functional scale, and a symptomatic scale were compared for the AI regimen and the three novel antitumor agents. Results The mean global health status score of the patients treated with the AI regimen was significantly different from that of those treated with one of the three novel antitumor agents (37.9 and 56.8, respectively). No significant differences were found in the five functional scores. The nausea and vomiting score was significantly different between the AI regimen and eribulin. The constipation score was significantly higher with the AI regimen, and the diarrhea score was significantly higher with pazopanib. Conclusions Compared to the AI regimen, patients can continue treatment with one of the three innovative antitumor agents while maintaining QOL, even with progressive disease. In particular, of the three innovative antitumor agents compared to the AI regimen, patients treated with pazopanib were able to maintain social activities during treatment. In the second-line and subsequent treatments, we could not clearly show a different effect on maintenance of a better QOL among the three innovative drugs, so additional work in the future is needed. If we clarify which of the three drugs most affects QOL, recommendations can be made regarding treatment selection for the second-line and subsequent treatments.

scholarly journals Perioperative treatment of soft-tissue sarcoma

2020 ◽  
Vol 13 (2) ◽  
pp. 174-178 ◽  
Author(s):  
Christian Rothermundt
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Standard Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Recurrence ◽  
Improved Outcomes ◽  
Number Of Patients ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Neo Adjuvant Chemotherapy

SummaryThe standard treatment of high-risk localized extremity and trunk soft-tissue sarcoma is wide local excision and radiation therapy, which can be delivered pre- or postoperatively. Improved care for sarcoma patients at expert centres with multidisciplinary tumour boards, specialized pathologists, surgeons, radio-oncologists, and medical oncologists, according to national or international guidelines, has improved outcomes. Yet, a substantial number of patients will experience disease recurrence with metastatic spread and ultimately die from their disease. In many solid tumours neo/adjuvant chemotherapy has become an accepted standard treatment, whereas in soft-tissue sarcoma discussions on the use of cytotoxic therapy in localized and resectable disease are ongoing. Some centres demonstrated the feasibility and now treat with concomitant neoadjuvant chemoradiotherapy as standard. Others argue that treatments should be given in the order of the accompanying evidence (surgery → radiotherapy → chemotherapy), which does not take biology of the disease into account and probably attempts to simplify complex decision making processes. It is important to enhance our ability to identify patients at highest risk of recurrence, and to generate data and develop tools to predict which patients will benefit from neo/adjuvant systemic therapy most.

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