Targeted therapies for sarcomas: new roles for the pathologist
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Updated: May 7, 2026

A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
Tariq Al-Zaid1, Neeta Somaiah, Alexander J Lazar
1Department of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Abstract:
Sarcomas are a heterogeneous family of mesenchymal malignancies that employ an impressive variety of pathogenetic mechanisms. The traditional role of the pathologist in this field has been to ensure accurate diagnosis and histological grading to direct therapy. More recently, with the advent of targeted therapies directed at particular molecular alterations, the role of the pathologist has expanded and increased awareness of the genetic features of sarcomas is needed to deliver optimal multidisciplinary care. This review discusses these trends and briefly enumerates many of the molecular derangements and targeted agents currently used or under investigation in soft tissue sarcoma. A few sarcomas are highlighted in more detail to illustrate how pathologists can exert positive influence on patient care - not just through diagnosis and grading, but also with molecular characterizations. Featured sarcomas include alveolar soft part sarcoma, dermatofibrosarcoma protuberans, gastrointestinal stromal tumour, inflammatory myofibroblastic tumour and PEComas.
Insights
Pathologists play a crucial role in diagnosing and grading sarcomas. Understanding sarcoma genetics is vital for targeted therapies and improved patient care, expanding the pathologist
Area of Science:
- Oncology
- Pathology
- Genetics
Background:
- Sarcomas are diverse cancers originating from connective tissues.
- Traditional pathology focuses on diagnosis and grading for treatment.
- Emerging targeted therapies necessitate understanding molecular alterations.
Purpose of the Study:
- To review the evolving role of pathologists in sarcoma care.
- To highlight the importance of molecular characterization in sarcomas.
- To discuss targeted therapies and their impact on patient management.
Main Methods:
- Literature review of sarcoma pathogenetic mechanisms.
- Enumeration of molecular derangements in soft tissue sarcoma.
- Discussion of targeted agents in clinical use or investigation.
Main Results:
- Pathologists' roles extend beyond diagnosis to molecular profiling.
- Awareness of genetic features is key for multidisciplinary sarcoma care.
- Specific sarcomas like DFSP and GIST exemplify the impact of molecular insights.
Conclusions:
- Molecular characterization by pathologists significantly influences sarcoma treatment.
- Targeted therapies offer new avenues for managing various sarcomas.
- An integrated approach combining pathology and molecular genetics optimizes patient outcomes.
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