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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
Contemporary Therapy for Advanced Soft-Tissue Sarcomas in Adults: A Review
Angela Pang1, Mariana Carbini2, Robert G Maki2
1Department of Haematology-Oncology, National University Cancer Institute, National University Healthcare System, Singapore2Sarcoma Program, Tisch Cancer Institute, Mount Sinai Medical Center, New York, New York.
Importance:
Immune checkpoint inhibitors have shown promising results in several cancers and are now put to the test in sarcomas. This brief summary presents data regarding the previously approved and newer agents for more common sarcomas and focuses on specific sarcoma histologic subtypes or novel approaches for which there is particular optimism. Approaches involving epigenetic agents, metabolic therapy, and modulators of the tumor microenvironment represent other ways the field of sarcoma medical oncology will progress in 2016 and beyond.
Observations:
A recent series of successful randomized trials provides new systemic therapy options for patients with metastatic soft-tissue sarcomas in the United States, after a gap of more than 10 years in which no new drugs were approved. The agents with most recent approval include pazopanib, trabectedin, and eribulin. As a sign that progress is not linear, 2 cousins of ifosfamide failed to show benefit in phase 3 trials, despite prior positive results of randomized phase 2 trials.
Conclusions And Relevance:
The biological features of each sarcoma subtype are associated with specific sensitivity patterns to chemotherapy, and despite their rarity, future trials will need to emphasize specific histologic subtypes (many with well-defined genetic alterations) to best fit diagnosis to therapy.
Insights
Newer agents like pazopanib, trabectedin, and eribulin offer hope for metastatic soft-tissue sarcomas. Future research will focus on specific sarcoma subtypes and novel therapies for improved treatment outcomes.
Area of Science:
- Medical oncology
- Cancer research
- Sarcoma treatment
Background:
- Immune checkpoint inhibitors show promise in various cancers and are being investigated for sarcomas.
- Recent advancements have introduced new systemic therapy options for metastatic soft-tissue sarcomas after a decade-long gap.
- Pazopanib, trabectedin, and eribulin are among the recently approved agents.
Purpose of the Study:
- To review data on approved and emerging agents for common sarcomas.
- To highlight specific sarcoma histologic subtypes and novel approaches with optimistic potential.
- To discuss future directions in sarcoma medical oncology, including epigenetic agents and metabolic therapy.
Main Methods:
- Review of recent randomized trials for metastatic soft-tissue sarcomas.
- Analysis of approved systemic therapy agents.
- Examination of novel therapeutic approaches and tumor microenvironment modulators.
Main Results:
- Pazopanib, trabectedin, and eribulin represent new treatment options for metastatic soft-tissue sarcomas.
- Despite some setbacks (e.g., ifosfamide analogs), progress in sarcoma systemic therapy is evident.
- Understanding sarcoma subtype-specific sensitivities to chemotherapy is crucial.
Conclusions:
- Sarcoma treatment efficacy is linked to the biological features of specific subtypes.
- Future clinical trials must focus on distinct histologic subtypes with defined genetic alterations.
- Tailoring diagnosis to therapy is essential for optimizing treatment in rare sarcoma subtypes.
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