Neoadjuvant chemotherapy in soft tissue sarcomas: Latest evidence and clinical implications

Sandro Pasquali, Alessandro Gronchi

Research output: Contribution to journalReview article

34 Citations (Scopus)

Abstract

Soft tissue sarcomas are a rare and multifaceted group of solid tumours. Neoadjuvant chemotherapy is increasingly used to limit loss of function after wide surgical excision with the ultimate aim of improving patient survival. Recently, advances in the identification of effective treatment strategies and improvements in patient risk stratification have been reached. A randomized trial demonstrated that neoadjuvant epirubicin and ifosfamide improves survival of patients affected by five high-risk soft tissue sarcoma histologies of trunk and extremities, including undifferentiated pleomorphic sarcoma, myxoid liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumours, and leiomyosarcoma. Selection of patients for these treatments is expected to be improved by the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging system, as it tailors T-stage categories on primary tumour site and considers a prognostic nomogram for retroperitoneal sarcoma, which also includes soft tissue sarcoma histology and other patient and tumour features not directly included in the TNM staging. Within this framework, this article will present neoadjuvant treatment strategies for high-risk soft tissue sarcoma, emphasizing the most recent advances and discussing the need for further research to improve the effectiveness of neoadjuvant treatments.

Original languageEnglish
Pages (from-to)415-429
Number of pages15
JournalTherapeutic Advances in Medical Oncology
Volume9
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Sarcoma
Drug Therapy
Neoplasm Staging
Neoadjuvant Therapy
Histology
Myxoid Liposarcoma
Synovial Sarcoma
Neoplasms
Epirubicin
Nomograms
Ifosfamide
Survival
Leiomyosarcoma
Neurilemmoma
Patient Selection
Extremities
Research

Keywords

  • chemotherapy
  • neoadjuvant
  • radiotherapy
  • soft tissue sarcoma
  • trial

ASJC Scopus subject areas

  • Oncology

Cite this

Neoadjuvant chemotherapy in soft tissue sarcomas : Latest evidence and clinical implications. / Pasquali, Sandro; Gronchi, Alessandro.

In: Therapeutic Advances in Medical Oncology, Vol. 9, No. 6, 01.06.2017, p. 415-429.

Research output: Contribution to journalReview article

@article{7efe33c8fcea4e24b5710f2e47c2b4af,
title = "Neoadjuvant chemotherapy in soft tissue sarcomas: Latest evidence and clinical implications",
abstract = "Soft tissue sarcomas are a rare and multifaceted group of solid tumours. Neoadjuvant chemotherapy is increasingly used to limit loss of function after wide surgical excision with the ultimate aim of improving patient survival. Recently, advances in the identification of effective treatment strategies and improvements in patient risk stratification have been reached. A randomized trial demonstrated that neoadjuvant epirubicin and ifosfamide improves survival of patients affected by five high-risk soft tissue sarcoma histologies of trunk and extremities, including undifferentiated pleomorphic sarcoma, myxoid liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumours, and leiomyosarcoma. Selection of patients for these treatments is expected to be improved by the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging system, as it tailors T-stage categories on primary tumour site and considers a prognostic nomogram for retroperitoneal sarcoma, which also includes soft tissue sarcoma histology and other patient and tumour features not directly included in the TNM staging. Within this framework, this article will present neoadjuvant treatment strategies for high-risk soft tissue sarcoma, emphasizing the most recent advances and discussing the need for further research to improve the effectiveness of neoadjuvant treatments.",
keywords = "chemotherapy, neoadjuvant, radiotherapy, soft tissue sarcoma, trial",
author = "Sandro Pasquali and Alessandro Gronchi",
year = "2017",
month = "6",
day = "1",
doi = "10.1177/1758834017705588",
language = "English",
volume = "9",
pages = "415--429",
journal = "Therapeutic Advances in Medical Oncology",
issn = "1758-8340",
publisher = "SAGE Publications Inc.",
number = "6",

}

TY - JOUR

T1 - Neoadjuvant chemotherapy in soft tissue sarcomas

T2 - Latest evidence and clinical implications

AU - Pasquali, Sandro

AU - Gronchi, Alessandro

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Soft tissue sarcomas are a rare and multifaceted group of solid tumours. Neoadjuvant chemotherapy is increasingly used to limit loss of function after wide surgical excision with the ultimate aim of improving patient survival. Recently, advances in the identification of effective treatment strategies and improvements in patient risk stratification have been reached. A randomized trial demonstrated that neoadjuvant epirubicin and ifosfamide improves survival of patients affected by five high-risk soft tissue sarcoma histologies of trunk and extremities, including undifferentiated pleomorphic sarcoma, myxoid liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumours, and leiomyosarcoma. Selection of patients for these treatments is expected to be improved by the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging system, as it tailors T-stage categories on primary tumour site and considers a prognostic nomogram for retroperitoneal sarcoma, which also includes soft tissue sarcoma histology and other patient and tumour features not directly included in the TNM staging. Within this framework, this article will present neoadjuvant treatment strategies for high-risk soft tissue sarcoma, emphasizing the most recent advances and discussing the need for further research to improve the effectiveness of neoadjuvant treatments.

AB - Soft tissue sarcomas are a rare and multifaceted group of solid tumours. Neoadjuvant chemotherapy is increasingly used to limit loss of function after wide surgical excision with the ultimate aim of improving patient survival. Recently, advances in the identification of effective treatment strategies and improvements in patient risk stratification have been reached. A randomized trial demonstrated that neoadjuvant epirubicin and ifosfamide improves survival of patients affected by five high-risk soft tissue sarcoma histologies of trunk and extremities, including undifferentiated pleomorphic sarcoma, myxoid liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumours, and leiomyosarcoma. Selection of patients for these treatments is expected to be improved by the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging system, as it tailors T-stage categories on primary tumour site and considers a prognostic nomogram for retroperitoneal sarcoma, which also includes soft tissue sarcoma histology and other patient and tumour features not directly included in the TNM staging. Within this framework, this article will present neoadjuvant treatment strategies for high-risk soft tissue sarcoma, emphasizing the most recent advances and discussing the need for further research to improve the effectiveness of neoadjuvant treatments.

KW - chemotherapy

KW - neoadjuvant

KW - radiotherapy

KW - soft tissue sarcoma

KW - trial

UR - http://www.scopus.com/inward/record.url?scp=85020205653&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020205653&partnerID=8YFLogxK

U2 - 10.1177/1758834017705588

DO - 10.1177/1758834017705588

M3 - Review article

AN - SCOPUS:85020205653

VL - 9

SP - 415

EP - 429

JO - Therapeutic Advances in Medical Oncology

JF - Therapeutic Advances in Medical Oncology

SN - 1758-8340

IS - 6

ER -