Soft Tissue Sarcoma with Jonathan C. Trent, MD, PhD and Shreyaskumar R. Patel, MD: Case 1 - Episode 4
Would you consider additional chemotherapy in this patient?
The patient has gone through a combination of gemcitabine and docetaxel in the frontline and adriamycin and dacarbazine as the second-line regimen. The patient also had pazopanib as the targeted therapy in the third line. Important things to address at this time, and it should be a mutual decision between the patient family and the treating team on what the goals are, are that this patient has an incurable tumor and fourth-line and beyond therapies are going to have marginal benefit that are not likely to be durable. The choice as to whether one would offer therapy or not becomes a mutual decision.
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