Leiomyosarcoma: Principles of Management

Overview

Journal Intractable Rare Dis Res

Date 2014 Oct 25

PMID 25343116

Citations 20

Authors

Juan Martin-Liberal

Affiliations

Soon will be listed here.

Abstract

The term soft-tissue sarcomas (STS) embraces more than 50 different sub-types that are often associated with poor prognosis. Only a very limited number of agents are active against STS. Doxorubicin and ifosfamide are widely accepted as the most effective compounds. However, their low response rates and poor impact on the overall survival of the patients illustrate the need for new treatment options. Among them, leiomyosarcomas are one of the most frequently occurring subtypes. In spite of the relatively high incidence of leiomyosarcomas, the overall effectiveness of the currently available systemic treatments is still poor. The heterogeneity of its biological origin, clinical behavior and responsiveness to chemotherapy, together with the scarcity of successful clinical trials, makes the treatment of leiomyosarcoma especially challenging. In addition, the evidence-based treatment for leiomyosarcoma comes from trials in which, in the majority of cases, no distinctions have been made among the different STS sub-types. As a result, every therapeutic decision should be made on an individual basis in collaboration with the patient. The results of new specific histology-designed clinical trials should aid decision making in this complex field.

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References

Italiano A, Toulmonde M, Stoeckle E, Kind M, Kantor G, Coindre J . Clinical outcome of leiomyosarcomas of vascular origin: comparison with leiomyosarcomas of other origin. Ann Oncol. 2010; 21(9):1915-1921. DOI: 10.1093/annonc/mdq039. View

Ferrari A, Sultan I, Huang T, Rodriguez-Galindo C, Shehadeh A, Meazza C . Soft tissue sarcoma across the age spectrum: a population-based study from the Surveillance Epidemiology and End Results database. Pediatr Blood Cancer. 2011; 57(6):943-9. PMC: 4261144. DOI: 10.1002/pbc.23252. View

Van Glabbeke M, Van Oosterom A, Oosterhuis J, Mouridsen H, Crowther D, Somers R . Prognostic factors for the outcome of chemotherapy in advanced soft tissue sarcoma: an analysis of 2,185 patients treated with anthracycline-containing first-line regimens--a European Organization for Research and Treatment of Cancer Soft Tissue and.... J Clin Oncol. 1999; 17(1):150-7. DOI: 10.1200/JCO.1999.17.1.150. View

Van Glabbeke M, Verweij J, Judson I, Nielsen O . Progression-free rate as the principal end-point for phase II trials in soft-tissue sarcomas. Eur J Cancer. 2002; 38(4):543-9. DOI: 10.1016/s0959-8049(01)00398-7. View

Edris B, Fletcher J, West R, van de Rijn M, Beck A . Comparative gene expression profiling of benign and malignant lesions reveals candidate therapeutic compounds for leiomyosarcoma. Sarcoma. 2012; 2012:805614. PMC: 3420093. DOI: 10.1155/2012/805614. View

Hardman M, Roman J, Burnett A, Santin A . Metastatic uterine leiomyosarcoma regression using an aromatase inhibitor. Obstet Gynecol. 2007; 110(2 Pt 2):518-20. DOI: 10.1097/01.AOG.0000267533.56546.c2. View

DAdamo D, Anderson S, Albritton K, Yamada J, Riedel E, Scheu K . Phase II study of doxorubicin and bevacizumab for patients with metastatic soft-tissue sarcomas. J Clin Oncol. 2005; 23(28):7135-42. DOI: 10.1200/JCO.2005.16.139. View

Farid M, Ong W, Tan M, Foo L, Lim Y, Chia W . The influence of primary site on outcomes in leiomyosarcoma: a review of clinicopathologic differences between uterine and extrauterine disease. Am J Clin Oncol. 2012; 36(4):368-74. DOI: 10.1097/COC.0b013e318248dbf4. View

Stiller C, Trama A, Serraino D, Rossi S, Navarro C, Chirlaque M . Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer. 2012; 49(3):684-95. DOI: 10.1016/j.ejca.2012.09.011. View

10.

Leahy M, Garcia Del Muro X, Reichardt P, Judson I, Staddon A, Verweij J . Chemotherapy treatment patterns and clinical outcomes in patients with metastatic soft tissue sarcoma. The SArcoma treatment and Burden of Illness in North America and Europe (SABINE) study. Ann Oncol. 2012; 23(10):2763-2770. DOI: 10.1093/annonc/mds070. View

11.

Sleijfer S, Ouali M, Van Glabbeke M, Krarup-Hansen A, Rodenhuis S, Cesne A . Prognostic and predictive factors for outcome to first-line ifosfamide-containing chemotherapy for adult patients with advanced soft tissue sarcomas: an exploratory, retrospective analysis on large series from the European Organization for Research.... Eur J Cancer. 2009; 46(1):72-83. DOI: 10.1016/j.ejca.2009.09.022. View

12.

OCearbhaill R, Zhou Q, Iasonos A, Soslow R, Leitao M, Aghajanian C . Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors. Gynecol Oncol. 2009; 116(3):424-9. PMC: 4852374. DOI: 10.1016/j.ygyno.2009.10.064. View

13.

Jain S, Xu R, Prieto V, Lee P . Molecular classification of soft tissue sarcomas and its clinical applications. Int J Clin Exp Pathol. 2010; 3(4):416-28. PMC: 2872748. View

14.

Uchida T, Nakakawaji K, Sakamoto J, Kojima H, Murakami H, Kato J . The effectiveness of medroxyprogesterone in the treatment of multiple metastasizing leiomyosarcomas: report of a case. Surg Today. 1996; 26(2):138-41. DOI: 10.1007/BF00311780. View

15.

Beck A, Lee C, Witten D, Gleason B, Edris B, Espinosa I . Discovery of molecular subtypes in leiomyosarcoma through integrative molecular profiling. Oncogene. 2009; 29(6):845-54. PMC: 2820592. DOI: 10.1038/onc.2009.381. View

16.

van der Graaf W, Blay J, Chawla S, Kim D, Bui-Nguyen B, Casali P . Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012; 379(9829):1879-86. DOI: 10.1016/S0140-6736(12)60651-5. View

17.

Van Oosterom A, Mouridsen H, Nielsen O, Dombernowsky P, Krzemieniecki K, Judson I . Results of randomised studies of the EORTC Soft Tissue and Bone Sarcoma Group (STBSG) with two different ifosfamide regimens in first- and second-line chemotherapy in advanced soft tissue sarcoma patients. Eur J Cancer. 2002; 38(18):2397-406. DOI: 10.1016/s0959-8049(02)00491-4. View

18.

Koivisto-Korander R, Leminen A, Heikinheimo O . Mifepristone as treatment of recurrent progesterone receptor-positive uterine leiomyosarcoma. Obstet Gynecol. 2007; 109(2 Pt2):512-4. DOI: 10.1097/01.AOG.0000223228.23289.0f. View