title: Dermatofibrosarcoma protuberans: from translocation to targeted therapy.
abstract: Dermatofibrosarcoma protuberans (DFSP), the most common dermal sarcoma, is a low-grade, slow growing fibroblastic malignant neoplasm that most frequently affects middle aged adults and is characterized by a high local recurrence rate and a low propensity for metastasis. Wide surgical resection or Mohs micrographic surgery (MMS) are the preferred approaches for localized disease, while radiation therapy is warranted for inoperable disease or for cases with positive margins where re-excision is not possible. DFSP is generally regarded as refractory to conventional chemotherapy. Treatment options for systemic disease were limited until the discovery of a unique translocation, t(17;22)(q22;q13) (COL1A1;PDGFB) found in a majority of cases. In recent years, imatinib, a PDGFβR, ABL and KIT inhibitor, has revolutionized systemic therapy in DFSP. In this review, we summarize the epidemiological, clinical, histological and genetic characteristics of DFSP and update the readers on its current management.
authors.affiliation: Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Noujaim
authors.affiliation: Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
authors.forename: Khin
authors.initials: K
authors.lastname: Thway
authors.affiliation: Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
authors.forename: Cyril
authors.initials: C
authors.lastname: Fisher
authors.affiliation: Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Jones
keywords: Dermatofibrosarcoma protuberans (DFSP); Mohs micrographic surgery (MMS); imatinib; targeted therapy; translocation