Neoadjuvant treatment: A novel standard?

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review The aim of this study was to summarize developments in the adjuvant/neoadjuvant chemotherapy of high-risk adult-Type soft tissue sarcomas (STS). Recent findings The role of adjuvant/neaodjuvant chemotherapy in these patients is controversial, with a meta-Analysis suggesting a 10% survival benefit. Recently, a randomized controlled trial in high-risk STS of extremities and trunk wall showed a 20% improvement in progression-free and overall survival after three preoperative cycles of epirubicin along with ifosfamide compared with a histology-Tailored chemotherapy. This study has major strengths, including the selected high-risk population and the full-dose chemotherapy regimen. However, this was an interim analysis with a short follow-up in a trial originally planned to test the superiority of a histology-driven chemotherapy. As to high-risk patient selection, the new AJCC TNM staging system adds primary tumour site as a stratifying factor, while available prognostic nomograms account for additional criteria. Summary A recent trial strengthens perioperative chemotherapy as an option for high-risk STS patients within a shared decision-making process. If the final analysis of this trial confirms the currently observed progression-free and overall survival benefits, perioperative chemotherapy may become a standard. Also, new staging tools may refine our ability to select patients with a risk high enough as to deserve chemotherapy.

Original languageEnglish
Pages (from-to)253-259
Number of pages7
JournalCurrent Opinion in Oncology
Volume29
Issue number4
DOIs
Publication statusPublished - Jul 1 2017

Keywords

  • adjuvant
  • chemotherapy
  • neoadjuvant
  • nomogram
  • radiotherapy
  • randomized trial
  • sarcoma
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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