Purpose of review The aim of this study was to summarize developments in the adjuvant/neoadjuvant chemotherapy of high-risk adult-Type soft tissue sarcomas (STS). Recent findings The role of adjuvant/neaodjuvant chemotherapy in these patients is controversial, with a meta-Analysis suggesting a 10% survival benefit. Recently, a randomized controlled trial in high-risk STS of extremities and trunk wall showed a 20% improvement in progression-free and overall survival after three preoperative cycles of epirubicin along with ifosfamide compared with a histology-Tailored chemotherapy. This study has major strengths, including the selected high-risk population and the full-dose chemotherapy regimen. However, this was an interim analysis with a short follow-up in a trial originally planned to test the superiority of a histology-driven chemotherapy. As to high-risk patient selection, the new AJCC TNM staging system adds primary tumour site as a stratifying factor, while available prognostic nomograms account for additional criteria. Summary A recent trial strengthens perioperative chemotherapy as an option for high-risk STS patients within a shared decision-making process. If the final analysis of this trial confirms the currently observed progression-free and overall survival benefits, perioperative chemotherapy may become a standard. Also, new staging tools may refine our ability to select patients with a risk high enough as to deserve chemotherapy.
Neoadjuvant treatment: A novel standard? / S. Pasquali, E. Palassini, S. Stacchiotti, P.G. Casali, A. Gronchi. - In: CURRENT OPINION IN ONCOLOGY. - ISSN 1040-8746. - 29:4(2017), pp. 253-259.
|Titolo:||Neoadjuvant treatment: A novel standard?|
|Parole Chiave:||adjuvant; chemotherapy; neoadjuvant; nomogram; radiotherapy; randomized trial; sarcoma; survival|
|Settore Scientifico Disciplinare:||Settore MED/06 - Oncologia Medica|
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/CCO.0000000000000372|
|Appare nelle tipologie:||01 - Articolo su periodico|