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Unresectable Soft Tissue Sarcoma

MedGen UID:
1655763
•Concept ID:
C4727003
•
Neoplastic Process

Definition

Soft tissue sarcoma that is not amenable to surgical resection. [from NCI]

Professional guidelines

PubMed

Is there a place for definitive radiotherapy in the treatment of unresectable soft-tissue sarcoma? A systematic review.
Allignet B, Sunyach MP, Geets X, Waissi W
Acta Oncol 2022 Jun;61(6):720-729. Epub 2022 May 15 doi: 10.1080/0284186X.2022.2066983. PMID: 35574815
Drug-eluting bead transarterial chemoembolization in the treatment for unresectable soft tissue sarcoma refractory to systemic chemotherapy: a preliminary evaluation of efficacy and safety.
Ni JY, Sun HL, Chen YT, Luo JH, Wang WD, Jiang XY, Chen D, Xu LF
J Cancer Res Clin Oncol 2018 Jan;144(1):157-163. Epub 2017 Oct 9 doi: 10.1007/s00432-017-2530-3. PMID: 28993945
Olaratumab for the treatment of soft-tissue sarcoma.
Pender A, Jones RL
Future Oncol 2017 Oct;13(24):2151-2157. Epub 2017 Jul 26 doi: 10.2217/fon-2017-0210. PMID: 28745071

Recent clinical studies

Etiology

Long-term outcomes after definitive radiotherapy with modern techniques for unresectable soft tissue sarcoma.
Allignet B, Waissi W, Geets X, Dufresne A, Brahmi M, Ray-Coquard I, Blay JY, Bouhamama A, Meeus P, Vaz G, Gouin F, Moncharmont C, Sunyach MP
Radiother Oncol 2022 Aug;173:55-61. Epub 2022 May 28 doi: 10.1016/j.radonc.2022.05.020. PMID: 35640770
Oncological outcome after hyperthermic isolated limb perfusion for primarily unresectable versus locally recurrent soft tissue sarcoma of extremities.
Vassos N, Brunner M, Perrakis A, Göhl J, Grützmann R, Hohenberger W, Croner RS
Surg Oncol 2020 Dec;35:162-168. Epub 2020 Aug 12 doi: 10.1016/j.suronc.2020.08.010. PMID: 32882523
Pazopanib-induced fatal heart failure in a patient with unresectable soft tissue sarcoma and review of literature.
Karaağaç M, Eryılmaz MK
J Oncol Pharm Pract 2020 Apr;26(3):768-774. Epub 2019 Sep 23 doi: 10.1177/1078155219875797. PMID: 31547750
First-line treatment of metastatic or locally advanced unresectable soft tissue sarcomas with conatumumab in combination with doxorubicin or doxorubicin alone: a phase I/II open-label and double-blind study.
Demetri GD, Le Cesne A, Chawla SP, Brodowicz T, Maki RG, Bach BA, Smethurst DP, Bray S, Hei YJ, Blay JY
Eur J Cancer 2012 Mar;48(4):547-63. Epub 2012 Jan 11 doi: 10.1016/j.ejca.2011.12.008. PMID: 22240283
Isolated limb perfusion with tumor necrosis factor-alpha and melphalan for patients with unresectable soft tissue sarcoma of the extremities.
Noorda EM, Vrouenraets BC, Nieweg OE, van Coevorden F, van Slooten GW, Kroon BB
Cancer 2003 Oct 1;98(7):1483-90. doi: 10.1002/cncr.11648. PMID: 14508836

Diagnosis

A Phase 1b Dose Escalation Trial of NC-6300 (Nanoparticle Epirubicin) in Patients with Advanced Solid Tumors or Advanced, Metastatic, or Unresectable Soft-tissue Sarcoma.
Chawla SP, Goel S, Chow W, Braiteh F, Singh AS, Olson JEG, Osada A, Bobe I, Riedel RF
Clin Cancer Res 2020 Aug 15;26(16):4225-4232. Epub 2020 May 7 doi: 10.1158/1078-0432.CCR-20-0591. PMID: 32381487
Pazopanib-induced fatal heart failure in a patient with unresectable soft tissue sarcoma and review of literature.
Karaağaç M, Eryılmaz MK
J Oncol Pharm Pract 2020 Apr;26(3):768-774. Epub 2019 Sep 23 doi: 10.1177/1078155219875797. PMID: 31547750
Olaratumab for the treatment of soft-tissue sarcoma.
Pender A, Jones RL
Future Oncol 2017 Oct;13(24):2151-2157. Epub 2017 Jul 26 doi: 10.2217/fon-2017-0210. PMID: 28745071
First-line treatment of metastatic or locally advanced unresectable soft tissue sarcomas with conatumumab in combination with doxorubicin or doxorubicin alone: a phase I/II open-label and double-blind study.
Demetri GD, Le Cesne A, Chawla SP, Brodowicz T, Maki RG, Bach BA, Smethurst DP, Bray S, Hei YJ, Blay JY
Eur J Cancer 2012 Mar;48(4):547-63. Epub 2012 Jan 11 doi: 10.1016/j.ejca.2011.12.008. PMID: 22240283
31Phosphorus-magnetic resonance spectroscopy to assess histologic tumor response noninvasively after isolated limb perfusion for soft tissue tumors.
Kettelhack C, Wickede Mv, Vogl T, Schneider U, Hohenberger P
Cancer 2002 Mar 1;94(5):1557-64. doi: 10.1002/cncr.10361. PMID: 11920514

Therapy

Phase II Study of Pembrolizumab in Combination with Doxorubicin in Metastatic and Unresectable Soft-Tissue Sarcoma.
Livingston MB, Jagosky MH, Robinson MM, Ahrens WA, Benbow JH, Farhangfar CJ, Foureau DM, Maxwell DM, Baldrige EA, Begic X, Symanowski JT, Steuerwald NM, Anderson CJ, Patt JC, Kneisl JS, Kim ES
Clin Cancer Res 2021 Dec 1;27(23):6424-6431. Epub 2021 Sep 2 doi: 10.1158/1078-0432.CCR-21-2001. PMID: 34475102
Pazopanib-induced fatal heart failure in a patient with unresectable soft tissue sarcoma and review of literature.
Karaağaç M, Eryılmaz MK
J Oncol Pharm Pract 2020 Apr;26(3):768-774. Epub 2019 Sep 23 doi: 10.1177/1078155219875797. PMID: 31547750
A phase II clinical study of 13-deoxy, 5-iminodoxorubicin (GPX-150) with metastatic and unresectable soft tissue sarcoma.
Van Tine BA, Agulnik M, Olson RD, Walsh GM, Klausner A, Frank NE, Talley TT, Milhem MM
Cancer Med 2019 Jun;8(6):2994-3003. Epub 2019 Apr 23 doi: 10.1002/cam4.2136. PMID: 31016866Free PMC Article
Olaratumab for the treatment of soft-tissue sarcoma.
Pender A, Jones RL
Future Oncol 2017 Oct;13(24):2151-2157. Epub 2017 Jul 26 doi: 10.2217/fon-2017-0210. PMID: 28745071
Clinical aspects of tumor necrosis factor-α signaling in hepatocellular carcinoma.
Jang MK, Kim HS, Chung YH
Curr Pharm Des 2014;20(17):2799-808. doi: 10.2174/13816128113199990587. PMID: 23944370

Prognosis

Is there a place for definitive radiotherapy in the treatment of unresectable soft-tissue sarcoma? A systematic review.
Allignet B, Sunyach MP, Geets X, Waissi W
Acta Oncol 2022 Jun;61(6):720-729. Epub 2022 May 15 doi: 10.1080/0284186X.2022.2066983. PMID: 35574815
Drug-eluting bead transarterial chemoembolization in the treatment for unresectable soft tissue sarcoma refractory to systemic chemotherapy: a preliminary evaluation of efficacy and safety.
Ni JY, Sun HL, Chen YT, Luo JH, Wang WD, Jiang XY, Chen D, Xu LF
J Cancer Res Clin Oncol 2018 Jan;144(1):157-163. Epub 2017 Oct 9 doi: 10.1007/s00432-017-2530-3. PMID: 28993945
Hyperthermic isolated limb perfusion. The switch from Steinmann pins to Omni-tract assisted isolation.
Stamatiou D, Ioannou CV, Kontopodis N, Michelakis D, Perisinakis K, Lasithiotakis K, Zoras O
J Surg Res 2017 Jun 1;213:147-157. Epub 2017 Feb 24 doi: 10.1016/j.jss.2017.02.023. PMID: 28601307
First-Line Aldoxorubicin vs Doxorubicin in Metastatic or Locally Advanced Unresectable Soft-Tissue Sarcoma: A Phase 2b Randomized Clinical Trial.
Chawla SP, Papai Z, Mukhametshina G, Sankhala K, Vasylyev L, Fedenko A, Khamly K, Ganjoo K, Nagarkar R, Wieland S, Levitt DJ
JAMA Oncol 2015 Dec;1(9):1272-80. doi: 10.1001/jamaoncol.2015.3101. PMID: 26378637
Isolated limb perfusion with tumor necrosis factor-alpha and melphalan for patients with unresectable soft tissue sarcoma of the extremities.
Noorda EM, Vrouenraets BC, Nieweg OE, van Coevorden F, van Slooten GW, Kroon BB
Cancer 2003 Oct 1;98(7):1483-90. doi: 10.1002/cncr.11648. PMID: 14508836

Clinical prediction guides

Oncological outcome after hyperthermic isolated limb perfusion for primarily unresectable versus locally recurrent soft tissue sarcoma of extremities.
Vassos N, Brunner M, Perrakis A, Göhl J, Grützmann R, Hohenberger W, Croner RS
Surg Oncol 2020 Dec;35:162-168. Epub 2020 Aug 12 doi: 10.1016/j.suronc.2020.08.010. PMID: 32882523
A Phase 1b Dose Escalation Trial of NC-6300 (Nanoparticle Epirubicin) in Patients with Advanced Solid Tumors or Advanced, Metastatic, or Unresectable Soft-tissue Sarcoma.
Chawla SP, Goel S, Chow W, Braiteh F, Singh AS, Olson JEG, Osada A, Bobe I, Riedel RF
Clin Cancer Res 2020 Aug 15;26(16):4225-4232. Epub 2020 May 7 doi: 10.1158/1078-0432.CCR-20-0591. PMID: 32381487
First-Line Aldoxorubicin vs Doxorubicin in Metastatic or Locally Advanced Unresectable Soft-Tissue Sarcoma: A Phase 2b Randomized Clinical Trial.
Chawla SP, Papai Z, Mukhametshina G, Sankhala K, Vasylyev L, Fedenko A, Khamly K, Ganjoo K, Nagarkar R, Wieland S, Levitt DJ
JAMA Oncol 2015 Dec;1(9):1272-80. doi: 10.1001/jamaoncol.2015.3101. PMID: 26378637
Covariate-adjusted adaptive randomization in a sarcoma trial with multi-stage treatments.
Thall PF, Wathen JK
Stat Med 2005 Jul 15;24(13):1947-64. doi: 10.1002/sim.2077. PMID: 15806621
High-dose chemotherapy with autologous hematopoietic stem-cell transplantation for advanced soft tissue sarcoma in adults.
Blay JY, Bouhour D, Ray-Coquard I, Dumontet C, Philip T, Biron P
J Clin Oncol 2000 Nov 1;18(21):3643-50. doi: 10.1200/JCO.2000.18.21.3643. PMID: 11054437

Recent systematic reviews

Is there a place for definitive radiotherapy in the treatment of unresectable soft-tissue sarcoma? A systematic review.
Allignet B, Sunyach MP, Geets X, Waissi W
Acta Oncol 2022 Jun;61(6):720-729. Epub 2022 May 15 doi: 10.1080/0284186X.2022.2066983. PMID: 35574815

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