New approaches in the treatment of soft tissue sarcomas
Abstract
This is a literature review on soft tissue sarcomas (STS) chemotherapy that brings up a new spin of treatment strategies development. During the past two decades there were almost no changes in this part of medical oncology and the new era in the treatment of the advanced disease recently started. New approaches nowadays maybe noticed not only in the treatment development but also in the evaluation and methodology of tumor responses because time to progression and overall survival are more clinically significant then short-term tumor shrinkage. According to histological subtype there are a lot of new treatment options- taxanes in angiosarcomas, temozolomide and bevacizumab in hemangiopericytomas, docetaxel and gemcitabine in leiomyosarcomas.The new antitumor agent trabectedine (ecteinascidine, Yondelis) isolated from tunicate Ecteinascidia turbinata shows encouraging antitumor activity and is approved by EMEA in European Union and in Russia. Pooled analysis of phase II studies of trabectedine showed 51,4 % of disease control rate (objective response + SD) in STS patients that failed conventional ifosfomide- antracycline regimens. Twenty nine percent (29%) of patients were alive after 2 years and overall survival was 10.3 month. Leiomyosarcomas and liposarcomas appeared to be particularly sensitive to the drug with noncumulative manageable toxicity. Many new molecules are under clinical investigation now that showed antitumor activity in STS such as bevacizumab, sorafenib, pazopanib, masatinib and many others, based on preliminary publications. So the new approach should be used for chemotherapy administration based on the tumor morphological subtype and grade.
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For citations:
Gorbunova V.A. New approaches in the treatment of soft tissue sarcomas. Bone and soft tissue sarcomas, tumors of the skin. 2009;(1):38-47. (In Russ.)
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