What`s new in soft tissue sarcoma research and treatment?

Research is ongoing in the area of soft tissue sarcomas. Scientists are learning more about causes and ways to prevent sarcomas, and doctors are working to improve treatments.

Basic research

Scientists have made progress in understanding how certain changes in the DNA of soft tissue cells cause sarcomas to develop. This information is already being applied to new tests to diagnose and classify sarcomas. This is important because accurate classification helps doctors select the most appropriate treatment. It is hoped that this information will soon lead to new strategies for treating these cancers, based on specific differences between normal and malignant soft tissue cells.

Classification

Classification of most cancers, including sarcomas, is based mostly on the way they look under a microscope. Recent research has shown that several different kinds of soft tissue sarcomas can look very similar under the microscope. By using new lab methods, researchers discovered that most cancers that used to be called malignant fibrous histiocytoma (MFH) are actually high-grade forms of liposarcoma, rhabdomyosarcoma, leiomyosarcoma, other sarcomas, and even carcinomas or lymphomas. About 10% to15% of cancers called MFH before, still cannot be given a precise classification, and these are now called pleomorphic undifferentiated sarcomas or undifferentiated pleomorphic sarcomas (although the current classification system of the World health Organization permits use of MFH as an alternate name).

Chemotherapy

Active research in chemotherapy for soft tissue sarcomas includes studies of new drugs and new ways to give drugs now available.

A new drug called trabectedin (Yondelis^®) has been shown to help some patients with soft tissue sarcomas. It is approved for use in Europe, but it is still being tested in the United States. In this country, it is currently only available as part of a clinical trial.

Targeted therapy

Even more active than research into chemotherapy is research into so-called targeted drugs. These are drugs that specifically block molecules in the cancer cells that cause the cancers to grow.

Other targeted drugs may also be helpful against sarcomas. For example, one type of sarcoma, gastrointestinal stromal tumor (discussed in a separate document) can be treated with a drug called imatinib (Gleevec^®). This drug is also helpful in treating desmoid tumors. Another targeted drug, sunitinib (Sutent^®), seems to slow the growth of many sarcomas. Sirolimus (Rapamune^®) has shown some promise in treating patients with PEComa, especially pulmonary lymphangioleiomyomatosis.

Anti-angiogenesis drugs

Drugs that block new blood vessel formation may help kill sarcomas by preventing their nourishment by the blood vessels. One such drug, bevacizumab (Avastin^®) has shown a small benefit in sarcoma patients, when given with doxorubicin. Other anti-angiogenesis drugs are currently being studied as treatment for sarcomas.

Radiation therapy

Studies of radiation therapy methods, for example, the roles of external beam radiation and brachytherapy (internal radiation) are also in progress. Use of intraoperative (during surgery) radiation therapy for abdominal and retroperitoneal sarcomas is being tested.