Molecular targeted therapies in non-GIST soft tissue sarcomas: what the radiologist needs to know
Sree Harsha Tirumani1, Jyothi P Jagannathan, Kevin O'Regan
1Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA. stirumani@partners.org
Abstract:
Non-gastrointestinal stromal soft tissue sarcomas are uncommon neoplasms that have a dismal prognosis due to a high incidence of metastases and a poor response to conventional chemotherapy. The identification of characteristic genetic alterations in several of these tumors has opened the window for molecular targeted therapies in patients who have failed conventional chemotherapy. Imaging plays a critical role in assessing the response to these novel therapeutic agents. Just like the response of gastrointestinal stromal tumors to imatinib, the response of non-gastrointestinal stromal soft tissue sarcomas to molecular targeted drugs is better evaluated on imaging by alternate tumor response criteria such as the Choi criteria. In addition, these drugs are associated with distinct class-specific drug toxicities that can come to attention for the first time on imaging. The purpose of this article is to provide a primer for the radiologist on the various molecular targeted therapies in advanced/metastatic non-gastrointestinal stromal soft tissue sarcomas with emphasis on the role of imaging in assessing treatment response and complications.
Insights
Molecular targeted therapies offer new hope for advanced soft tissue sarcomas resistant to chemotherapy. Radiologists must use specialized imaging criteria, like Choi criteria, to assess treatment response and identify drug toxicities.
Area of Science:
- Oncology
- Radiology
- Molecular Biology
Background:
- Non-gastrointestinal stromal soft tissue sarcomas (NGISTSS) have a poor prognosis due to metastasis and chemotherapy resistance.
- Genetic alterations in NGISTSS enable molecular targeted therapies for patients unresponsive to conventional treatments.
Purpose of the Study:
- To provide radiologists with a guide to molecular targeted therapies for advanced/metastatic NGISTSS.
- To emphasize the critical role of imaging in evaluating treatment response and complications associated with these novel therapies.
Main Methods:
- Review of molecular targeted therapies for advanced/metastatic NGISTSS.
- Discussion of imaging assessment of treatment response using alternate criteria (e.g., Choi criteria).
- Identification of class-specific drug toxicities detectable by imaging.
Main Results:
- Molecular targeted therapies represent a promising treatment avenue for advanced NGISTSS.
- Alternate imaging criteria, such as Choi criteria, are crucial for evaluating treatment efficacy.
- Imaging can detect unique drug-induced toxicities.
Conclusions:
- Molecular targeted therapies are transforming the management of advanced NGISTSS.
- Radiologists require specialized knowledge of these therapies, response assessment criteria, and potential imaging-detected complications.
- Effective imaging interpretation is vital for optimizing patient care in the era of targeted therapy.
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against specific...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against specific...