Soft Tissue Sarcoma with Jonathan C. Trent, MD, PhD and Shreyaskumar R. Patel, MD: Case 1 - Episode 8
What is the current standard of care for patients with invasive, unresectable leiomyosarcoma?
The standard of care for patients with invasive or unresectable leiomyosarcoma involves chemotherapy, and at times, radiation therapy as well. At our practice at the University of Miami Sylvester Cancer Center, we usually treat these patients initially with an anthracycline-based regimen. Second-line therapy would be with gemcitabine, usually in combination with docetaxel. These patients may be treated in third-line therapy with either pazopanib or a new agent called trabectedin.
The goal of therapy in a patient with unresectable or invasive leiomyosarcoma is to get reduction in the tumor size, such that it may, in the future, become resectable, or hopefully curable.
CASE: Soft-Tissue Sarcoma (Part 1)
Rachel F is a 58-year-old school teacher from Roanoke, Virginia. Her medical history is notable for mild hypertension and total knee replacement in 2011
Follow-up CT scan in January 2014 showed progression at multiple sites; at the time of follow up, her ECOG performance status was 1, with renal and hepatic function within normal limits
In September of 2014 she returns for follow-up, unable to work with increasing fatigue and abdominal pain, and her CT scan was consistent with progressive disease
After 4 months of therapy, she presents with worsening abdominal pain and declining performance status