Systemic Therapy for Advanced Soft Tissue Sarcoma
Systemic Therapy for Advanced Soft Tissue Sarcoma a, b Jennifer Y. Sheng, MD *, Sujana Movva, MD KEYWORDS Advanced soft tissue sarcoma Chemotherapy Novel therapies KEY POINTS Survival for advanced soft tissue sarcomas has improved significantly over the last 20 years because of advancements in histologic classification, improved treatment ap- proaches, and novel agents. An important factor guiding choice of therapy is soft tissue sarcoma subtype, as drugs such as eribulin and trabectedin may have particular activity in leiomyosarcoma and liposarcoma. Focus on angiogenesis inhibition has led to the approval of pazopanib for soft tissue sar- coma, and the pathway continues to be investigated in this disease. Toxicity is an important area of investigation in soft tissue sarcoma, and new agents, such as aldoxorubicin, may be alternatives with better safety profiles. Future studies on treatment of advanced soft tissue sarcoma will continue to focus on identification of novel drug targets, personalization of therapy, and combination immunotherapies. BACKGROUND Sarcomas are rare tumors that arise from or are differentiated from tissues of meso- dermal origin. They comprise less than 1% of all adult malignancies.1 In 2015 there were approximately 14, 900 new cases diagnosed, with 6360 deaths in the United States. Sarcomas are grouped into 2 general categories: soft tissues sarcomas and primary bone sarcomas, which have different staging and treatment approaches. This article includes a discussion of chemotherapy in advanced or refractory soft tis- sue sarcoma. Patients with metastatic disease are usually best managed with chemo- therapy. Distant metastasis occurs in up to 10% of patients, with the lung being the most common site in 83% of cases.2 Systemic therapy can involve cytotoxic a Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Uni- versity School of Medicine, Baltimore, MD, USA; b Department of Hematology/Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA * Corresponding author.
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