Advances in the Management of Soft Tissue Sarcomas - Focus on Emerging Therapies

Richard Maguire, Vladimir Andelkovic, Hanumant Chouhan and Gregory J Nolan

Department of Surgery, Gold Coast University Hospital, Australia
Department of Medical Oncology, Princess Alexandra Hospital, Australia
Department of Medicine, University of Queensland, Australia

^*Correspondance to: Richard Maguire 

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Abstract:

Soft Tissue Sarcoma (STS) encompasses a number of different clinical entities and is a rare form of cancer. This review focuses on treatment of extremity and trunk STS (excluding gastrointestinal stromal tumors), focusing on more recent treatment updates. Early disease is managed by surgical resection as a definitive curative procedure, sometimes in combination with radiotherapy. Newer techniques have decreased the burden of resection and allowed safer delivery of radiation. Adjuvant chemotherapy cannot be recommended as a general approach but is used in individual cases with high-risk, chemosensitive tumours. Advanced disease poses even more dilemmas in terms of management, and outcomes are generally poor. Research in systemic treatment has not had major breakthroughs in field of STS in the last 30 years. Doxorubicin is the standard first line treatment, while ifosfamide and dacarbazine are the most often used second line therapy. Eribulin and Trabectedin have been approved as second line therapies in more recent times. Targeted therapy is of particular interest and newer agents are becoming available for use. Pazopanib is used in nonadipocytic sarcoma after progression on chemotherapy. A number of newer agents are harbouring interest including olarutamab, cediranib and aldoxorubicin. The major focus in oncology research is currently in the field of immunotherapy, and more mature data in STS is awaited. Ultimately management is best performed in a specialist unit with a multi-disciplinary approach to improve patient outcomes. Clinical trial participation remains the preferred approach for patients with advanced disease.

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Cite the Article:

Maguire R, Andelkovic V, Chouhan H, Nolan GJ. Advances in the Management of Soft Tissue Sarcomas - Focus on Emerging Therapies. Clin Oncol. 2017; 2: 1189.