Current Stand on Systemic Therapy in Localized Soft Tissue Sarcomas: A Clinician's Perspective

Abstract

Soft tissue sarcomas (STS) are rare heterogenous tumors derived from mesenchymal tissue. While surgery represents the primary treatment modality, the high recurrence rates following surgery alone necessitate consideration for systemic therapy in high-risk sarcomas. Despite multiple trials and meta-analyses over the last 3 decades, the role of chemotherapy remains controversial. It is crucial to accurately identify patients with high-risk diseases who may benefit the most from adjuvant and/or neoadjuvant chemotherapy. There is renewed interest in the potential to improve outcomes in localized resectable STSs with the addition of targeted and immunotherapeutic strategies. The review presented here is a summary of current evidence on systemic therapy in resectable localized STSs of the trunk and extremities to facilitate clinician decision-making.

Keywords::

• adjuvant
• chemotherapy
• neoadjuvant
• nomogram
• sarcoma

Author contributions

A Sasi reviewed and compiled the data and wrote the manuscript. S Rastogi provided intellectual input and critically reviewed and edited the manuscript. All authors reviewed and approved the final version of the manuscript.

Acknowledgments

The authors would like to acknowledge every member of the sarcoma team of their center including research staff and nurses for their exemplary clinical services that have helped in building experience for the management of soft tissue sarcomas at the authors' center.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.