New Therapeutic strategies for soft tissue sarcomas

摘要: The treatment of patients with metastatic soft tissue sarcomas (STS) is complex. There are limited agents available and many associated significant toxicity. When evaluating a patient disease, physicians should ask themselves whether there role for surgery to render the free disease. Combination chemotherapy in who have not received adjuvant set-ting one option, particularly young good performance status. Sequential single-agent therapy more elderly or debilitated by their disease may be appropriate. Gemcitabine appears an agent activity, leiomyosarcomas. data regarding prolonged gemcitabine infusions suggest improved activity that was predicted based on intracellular levels. Because these data, infusion schedule used. In addition, because paucity effective agents, consideration clinical trial participation newly diagnosed appropriate, chemotherapy-insensitive histologies. newer (eg, ecteinascidin-743, epothilones, mammalian target rapamycin) undefined. Ecteinascidin-743 has been most extensively tested agent, its ability slow growth kinetics tumor stabilize it clinically intriguing. Data response BMS-247550 will published shortly help define further epothilones this preclinical rationale makes rapamycin inhibitors attractive muscle-derived neoplasms. cell-line suggesting rhabdomyosarcoma. These being adult STS likely pediatric histologies when safety population. SU11248 continue refractory imatinib mesylate well prove another active gastrointestinal stromal tumors. As depicted analysis efficacy, subgroup overlooked “come come all” approach trials STS. Identifying key targets specific helpful testing molecularly targeted agents. Biologic differences support histology-specific better understand site specifically biologic pathway relevance malignant potential For future achieve goal trials, cooperative group multi-institutional required obtain appropriate rare It also increasingly important committed obtaining validate hypotheses biology effectiveness therapeutic