[Systemic treatment of bone sarcoma, soft tissue sarcoma, GIST]

SYSTEMIC TREATMENT OF BONE SARCOMA, SOFT TISSUE SARCOMA, GIST. In osteosarcomas and Ewing sarcomas, the interest of systemic treatments is established in neo-adjuvant and adjuvant setting. Effective molecules are doxorubicin, alkyls, vinca-alkaloids and etoposide in Ewing's sarcomas, and methotrexate, doxorubicin, cisplatin, ifosfamide and etoposide in osteosarcoma. Several ongoing clinical studies raise the question of the value of maintenance treatment, including anti-angiogenic tyrosine kinase inhibitors. In soft tissue sarcomas, anthracyclines remain the reference molecules, either in the adjuvant (neo) or metastatic setting. Other anti-angiogenic chemotherapy molecules or tyrosine kinase inhibitors are authorized whose effectiveness differs depending on the histological subtype. In the adjuvant setting, many questions remain about the optimal use of chemotherapy and the selection of patients who could benefit from such a strategy. In high-risk gastro intestinal stromal tumor (GIST), the standard is 3 years adjuvant treatment with imatinib; a recent study asks whether treatment should continue for up to 6 years. In metastatic GIST, patients are treated with 4 successive lines of more or less specific tyrosine kinase inhibitors: imatinib, sunitinib, regorafenib, riprenib.