title: The importance of treating by histological subtype in advanced soft tissue sarcoma.
abstract: While surgical resection (±radiotherapy) is standard treatment for localized soft tissue sarcomas (STS), chemotherapy is the mainstay for managing locally advanced and metastatic disease. Expanding knowledge of the biologies and sensitivities of STS histotypes, in conjunction with results from a growing collection of retrospective reviews and prospective randomized studies, point to the importance of treating in consideration of histological subtype. Doxorubicin ± ifosfamide continues to be standard first-line therapy for most STS subtypes. Main options for second- or later-line therapy include trabectedin, dacarbazine, gemcitabine combinations, pazopanib and, most recently, eribulin. Using illustrative case studies, treatment options are reviewed for three of the more common STS subtypes - uterine leiomyosarcoma, liposarcoma and synovial sarcoma - with a focus on use of trabectedin.
authors.affiliation: MUsculoSkeletal Tumor Board of Excellence Sevilla (MUSTBE SEVILLA), Virgen del Rocío University Hospital, Sevilla, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Martín Broto
authors.affiliation: Department of Medical Oncology & Surgery, Institut Gustave Roussy, Villejuif, France.
authors.forename: Axel
authors.initials: A
authors.lastname: Le Cesne
authors.affiliation: Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Reichardt
mesh_terms: D003131:Combined Modality Therapy; D019468:Disease Management; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008080:Liposarcoma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D012509:Sarcoma / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013584:Sarcoma, Synovial / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
keywords: histology-driven therapy; leimoyosarcoma; liposarcoma; soft tissue sarcoma; synovial sarcoma; trabectedin