Adult soft tissue sarcomas: conventional therapies and molecularly targeted approaches.
The therapeutic approach to soft tissue sarcomas (STS) has evolved over the past two decades based on the results from randomized controlled trials, which are guiding physicians in the treatment decision-making process. Despite significant improvements in the control of local disease, a significant number of patients ultimately die of recurrent/metastatic disease following radical surgery due to a lack of effective adjuvant treatments. In addition, the characteristic chemoresistance of STS has compromised the therapeutic value of conventional antineoplastic agents in cases of unresectable advanced/metastatic disease. Therefore, novel therapeutic strategies are urgently needed to improve the prognosis of patients with STS. Recent advances in STS biology are paving the way to the development of molecularly targeted therapeutic strategies, the efficacy of which relies not only on the knowledge of the molecular mechanisms underlying cancer development/progression but also on the personalization of the therapeutic regimen according to the molecular features of individual tumours. In this work, we review the state-of-the-art of conventional treatments for STS and summarize the most promising findings in the development of molecularly targeted therapeutic approaches.
Mocellin
Simone
S
Surgery Branch, Department of Oncological and Surgical Sciences, University of Padova, Via Giustiniani 2, 35128 Padua, Italy. mocellins@hotmail.com
Rossi
Carlo R
CR
Brandes
Alba
A
Nitti
Donato
D
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D019496:Cancer Vaccines / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D015316:Genetic Therapy; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D061965:Matrix Metalloproteinase Inhibitors; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012509:Sarcoma / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019496:Cancer Vaccines; D004791:Enzyme Inhibitors; D006133:Growth Substances; D061965:Matrix Metalloproteinase Inhibitors