Soft Tissue Sarcoma 101

Welcome back to the SO Files! Shout out to our listeners for suggesting we dive into the world of soft tissue sarcomas. Soft Tissue Sarcomas are a very diverse group of cancers so today we focus on the two most common groupings – extremity vs retroperitoneal. We also bring Dr. Brian Van Tine on to focus on current trends in the field. Dr. Van Tine is an Associate Professor in the Division of Medical Oncology at Washington University who specializes in the treatment of soft tissue and bone sarcomas. [Brian Van Tine, MD,PhD]

We also plug our Surg Onc Files Questionnaire which we designed to get to know you all a little better. It takes less than a minute to fill out so be sure to click the link and give us some feedback!

Survey Monkey Link

Introduction and Sarcoma Overview: 0-25:50

Interview with Dr. Van Tine: 25:50-

Outline:

  • Extremity Soft Tissue Sarcoma
  • Retroperitoneal Soft Tissue Sarcoma
  • Interview with Dr. Brian Van Tine

As much as possible, our goal was to stay high yield and not get too bogged down in the details. Please refer to the NCCN guidelines for any additional information or questions, and remember to fill out our survey!!

NCCN Practice Guidelines Sarcoma

References

1. ANNOUNCE Trial (Eli Lilly Link); (ClinicalTrials.gov link)

Randomized, double-blind, Phase 3 study of olaratumab (anti-PDGFRA) in combination with doxorubicine, followed by olaratumab monotherapy; vs doxorubicin plus placebo followed by placebo, in patients with advanced or metastatic STS. Two primary endpoints were OS in the ITT population and in the Leimyosarcoma sub-population. There was no difference in survival between the study arms for either population. Findings were presented at ASCO 2019, and have not yet been published in a journal. 

Takeaway: No survival benefit gained by adding olaratumab to doxorubicin for locally advanced/metastatic STS.

2. SARC021 (Lancet link) (CT.gov link)

International, open-label, randomised, phase 3, multicenter trial. Included 81 sites in 13 countries. Patients randomly assigned to either doxorubicin alone or doxorubicin plus evofosfamide. 640 patients enrolled, primary endpoint was overall survival, not reached (18.4 months in combo group vs 19.0 months in DOX alone). 

Takeaway: No survival benefit gained by adding evofosfomide to doxorubicine for locally advanced or metastatic STS.

3. The Angiosarcoma Project

Nationwide clinical genomics study that allows patients diagnosed with angiosarcoma to send in their normal and tumor specimens. This in turn helps create a large tissue-bank which fuels large-scale sequencing efforts. Enrollment is ongoing. 


P.S. For those of you who like a good, old fashioned diagram, here’s one from Cameron’s Current Surgical Therapy that we found to be useful and easy to follow, enjoy!

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Current Surgical Therapy 12th Ed, Cameron et al. 2017