Current stand on systemic therapy in localized soft tissue sarcomas: a clinician's perspective

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Soft tissue sarcomas (STS) are rare, heterogeneous tumors originating from mesenchymal tissue.
• Surgery is the primary treatment, but high recurrence rates necessitate adjuvant or neoadjuvant systemic therapy for high-risk cases.
• The efficacy of chemotherapy in localized STS remains controversial despite extensive research.

Purpose of the Study:

• To review current evidence on systemic therapy for localized, resectable soft tissue sarcomas of the trunk and extremities.
• To aid clinicians in decision-making regarding adjuvant and/or neoadjuvant chemotherapy, targeted therapy, and immunotherapy.
• To identify high-risk STS patients who may benefit most from systemic treatment strategies.

Main Methods:

• Systematic review of clinical trials and meta-analyses published over the last three decades.
• Analysis of evidence for chemotherapy, targeted agents, and immunotherapeutic strategies in localized STS.
• Focus on studies involving resectable soft tissue sarcomas of the trunk and extremities.

Main Results:

• Evidence for the role of chemotherapy in localized STS remains controversial.
• Renewed interest exists in targeted and immunotherapeutic strategies to improve outcomes.
• Accurate identification of high-risk patients is crucial for optimizing systemic therapy benefits.

Conclusions:

• Systemic therapy decisions for localized, resectable STS require careful consideration of individual patient risk factors.
• Further research is needed to clarify the role of chemotherapy and explore the potential of novel targeted and immunotherapeutic approaches.
• This review provides a summary of current evidence to support clinical decision-making in managing localized STS.