title: Neoadjuvant treatment of soft-tissue sarcoma: a multimodality approach.
abstract: Unlike epithelial cancers that are both more homogeneous and easily categorized by their respective tissues of origin (e.g., breast or lung cancer), sarcomas represent a diverse class of molecularly distinct bone and soft-tissue mesenchymal neoplasms of more than 50 subtypes. This diversity, as well as the relative rarity of sarcomas as a whole, has presented challenges in conducting prospective randomized clinical trials to assess the value of neoadjuvant chemotherapy for any given subtype. Most clinical trials and meta-analyses have neglected the phenotypic and molecular heterogeneity differentiating one sarcoma subtype from another in favor of a simplified grouping that ensures timely trial completion. As the success of treating gastrointestinal stromal tumors (GISTs) with imatinib demonstrates, a decision to provide neoadjuvant chemotherapy must take into consideration both the subtype being treated and the effect such treatment would be expected to exert upon that subtype.
authors.affiliation: Department of Sarcoma Medical Oncology, M.D. Anderson Cancer Center, The University of Texas, Houston, Texas 77030, USA.
authors.forename: David
authors.initials: D
authors.lastname: Reynoso
authors.forename: Vivek
authors.initials: V
authors.lastname: Subbiah
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Trent
authors.forename: B Ashleigh
authors.initials: BA
authors.lastname: Guadagnolo
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Lazar
authors.forename: Robert
authors.initials: R
authors.lastname: Benjamin
authors.forename: Raphael E
authors.initials: RE
authors.lastname: Pollock
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ludwig
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents