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Cytotoxic Efficacy of Photodynamic Therapy in Osteosarcoma Cells In Vitro

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Neoadjuvant or Adjuvant Chemotherapy in Soft-Tissue Sarcoma?

Piotr Remiszewski^1,2, Kinga Filipek^1,3, Agata Pisklak^1,3

¹Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Current Oncology Reports

|March 28, 2025

Summary

Neoadjuvant chemotherapy (NAC) improves tumor removal in soft tissue sarcomas (STS), while perioperative chemotherapy shows mixed results. Nomograms help identify STS patients who benefit from chemotherapy, especially those with low survival predictions.

Keywords:

Adjuvant chemotherapy Neoadjuvant chemotherapy Perioperative chemotherapy Sarcoma Soft tissue sarcoma

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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies

A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies

Published on: July 28, 2020

Area of Science:

Oncology
Surgical Oncology
Medical Oncology

Background:

Soft tissue sarcomas (STS) treatment involves controversial approaches regarding neoadjuvant (pre-operative) and adjuvant (post-operative) chemotherapy.
Recent studies and guidelines offer evolving perspectives on the role of perioperative chemotherapy in STS management.

Purpose of the Study:

To compare the effectiveness of neoadjuvant chemotherapy (NAC) versus adjuvant chemotherapy (AC) in Soft Tissue Sarcomas (STS).
To review current evidence and guidelines regarding perioperative chemotherapy for STS.

Main Methods:

Literature review of recent studies and clinical trials (e.g., EORTC 62,771, EORTC 62,931, ISG-STS 1001, PERSARC).
Analysis of nomograms like Sarculator for predicting patient benefit from perioperative chemotherapy.
Evaluation of European guidelines on STS treatment.

Main Results:

Neoadjuvant chemotherapy (NAC) enhances complete tumor removal rates (R0 resection), particularly for large, high-grade STS, potentially reducing surgical morbidity.
Perioperative chemotherapy, specifically anthracycline and ifosfamide (AI) regimens, shows variable effects on recurrence-free survival (RFS) and overall survival (OS).
Nomograms and pooled analyses suggest AI chemotherapy may benefit STS patients with low predicted overall survival (OS < 60% or < 33% for 5-year OS), especially those with R1 resections.

Conclusions:

Neoadjuvant chemotherapy (NAC) is beneficial for improving surgical outcomes in STS.
The role of perioperative chemotherapy (AI regimens) in STS remains controversial, with evidence suggesting a survival benefit for select patient groups identified by nomograms.
Further research is needed to clarify optimal chemotherapy strategies for different STS subtypes and risk profiles.