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leiomyosarcoma therapy

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https://www.readbyqxmd.com/read/28229172/external-beam-radiation-therapy-combined-with-limb-sparing-surgery-in-elderly-patients-70%C3%A2-years-with-primary-soft-tissue-sarcomas-of-the-extremities-a%C3%A2-retrospective-analysis
#1
Claudia Andrä, Alexander Klein, Hans Roland Dürr, Josefine Rauch, Lars Hartwin Lindner, Thomas Knoesel, Martin Angele, Andrea Baur-Melnyk, Claus Belka, Falk Roeder
PURPOSE: To report our experience with EBRT combined with limb-sparing surgery in elderly patients (>70 years) with primary extremity soft tissue sarcomas (STS). METHODS: Retrospectively analyzed were 35 patients (m:f 18:17, median 78 years) who all presented in primary situation without nodal/distant metastases (Charlson score 0/1 in 18 patients; ≥2 in 17 patients). Median tumor size was 10 cm, mainly located in lower limb (83%). Stage at presentation (UICC7th) was Ib:3%, 2a:20%, 2b:20%, and 3:57%...
February 22, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28228279/loss-of-pten-is-associated-with-resistance-to-anti-pd-1-checkpoint-blockade-therapy-in-metastatic-uterine-leiomyosarcoma
#2
Suzanne George, Diana Miao, George D Demetri, Dennis Adeegbe, Scott J Rodig, Sachet Shukla, Mikel Lipschitz, Ali Amin-Mansour, Chandrajit P Raut, Scott L Carter, Peter Hammerman, Gordon J Freeman, Catherine J Wu, Patrick A Ott, Kwok-Kin Wong, Eliezer M Van Allen
Response to immune checkpoint blockade in mesenchymal tumors is poorly characterized, but immunogenomic dissection of these cancers could inform immunotherapy mediators. We identified a treatment-naive patient who has metastatic uterine leiomyosarcoma and has experienced complete tumor remission for >2 years on anti-PD-1 (pembrolizumab) monotherapy. We analyzed the primary tumor, the sole treatment-resistant metastasis, and germline tissue to explore mechanisms of immunotherapy sensitivity and resistance...
February 21, 2017: Immunity
https://www.readbyqxmd.com/read/28221727/docetaxel-bevacizumab-and-gemcitabine-for-very-high-risk-sarcomas-in-adolescents-and-young-adults-a-single-center-experience
#3
Christopher Kuo, Paul M Kent, Antonio D Logan, Karen B Tamulonis, Kristen L Dalton, Marta Batus, Karen Fernandez, Rebecca E Mcfall
BACKGROUND: Adolescent and young adult (AYA) patients with very high risk sarcomas have poor outcomes and are in need of novel therapies. PROCEDURE: From January 2005 to February 2016, we retrospectively identified all AYA patients with relapsed or metastatic high-grade sarcomas, who were treated with at least one cycle of docetaxel (T), bevacizumab (A), and gemcitabine (G) (TAG ; T = 100 mg/m(2) Day 8, A = 15 mg/kg Day 1, G = 1,000 mg/m(2) Days 1 and 8). RESULTS: Fourteen patients, median age of 20 (15-30), received a total of 80 cycles of TAG, and were followed for a median of 83 months...
April 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28209496/uterine-leiomyosarcoma-epidemiology-contemporary-treatment-strategies-and-the-impact-of-uterine-morcellation
#4
Stephanie Ricci, Rebecca L Stone, Amanda N Fader
Leiomyosarcoma, a rare tumor subtype, accounts for 1% of all uterine malignancies, but contributes to a significant proportion of uterine cancer deaths. Surgery is considered the mainstay of treatment for all soft tissue sarcomas, including uterine variants. However, uterine leiomyosarcoma is challenging to diagnose preoperatively and can mimic the appearance of benign uterine leiomyomas. Recently, concerns have grown in this regard, as surgeons have utilized uterine morcellation and myomectomy procedures unknowingly in the setting of occult uterine sarcoma...
February 13, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28191293/the-imaging-and-pathological-features-of-metastatic-leiomyosarcoma-in-the-gallbladder
#5
Yi Guo, Eleanor Chen, Darin J Davidson, Venu G Pillarisetty, Robin L Jones, Seth M Pollack
Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/28188392/current-status-of-uterine-leiomyosarcoma-in-the-tohoku-region-results-of-the-tohoku-translational-center-development-network-survey
#6
Hideki Tokunaga, Fumiaki Takahashi, Hiroki Yamamoto, Tsuyoshi Honda, Takafumi Watanabe, Tadahiro Shoji, Toru Sugiyama, Hidekazu Yamada, Tomoe Tando, Kosuke Yoshinaga, Satoko Kagabu, Takeo Otsuki, Shogo Kin, Yoshihito Yokoyama, Satoshige Wagatsuma, Kazuyo Sato, Hirokazu Sato, Takashi Oishi, Yuji Yoshida, Tadashi Hayasaka, Toshihiko Matsui, Noriaki Imai, Hidekazu Nishigori, Hiroaki Shimokawa, Nobuo Yaegashi, Yoh Watanabe
BACKGROUND: To prepare for a future clinical trial for improving the long-term prognosis of patients with uterine leiomyosarcoma (ULMS), we conducted a multi-institutional survey in the Tohoku region of Japan. METHODS: We conducted a retrospective cohort study between 2011 and 2014 in member institutions of the Tohoku Translational Research Center Development Network. RESULTS: A total of 53 patients with ULMS were registered in 31 institutions for the present survey...
February 10, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28184331/verticillin-a-inhibits-leiomyosarcoma-and-malignant-peripheral-nerve-sheath-tumor-growth-via-induction-of-apoptosis
#7
A Zewdu, G Lopez, D Braggio, C Kenny, D Constantino, H K Bid, K Batte, O H Iwenofu, N H Oberlies, C J Pearce, A M Strohecker, D Lev, R E Pollock
OBJECTIVE: The heterogeneity of soft tissue sarcoma (STS) represents a major challenge for the development of effective therapeutics. Comprised of over 50 different histology subtypes of various etiologies, STS subsets are further characterized as either karyotypically simple or complex. Due to the number of genetic anomalies associated with genetically complex STS, development of therapies demonstrating potency against this STS cluster is especially challenging and yet greatly needed...
November 2016: Clinical & Experimental Pharmacology
https://www.readbyqxmd.com/read/28181940/stable-disease-in-a-patient-with-metastatic-leiomyosarcoma-treated-with-trabectedin
#8
Ketty Tavella, Alessandro Villanucci, Laura Vannini, Daniele Lavacchi, Silvia Montelatici, Gianni Amunni, Teresita Mazzei
Leiomyosarcomas represent the most common variant of uterine sarcomas, and are also considered to be the least chemosensitive. To date, adriamycin and ifosfamide are believed to be the most effective drugs for its treatment, in addition to docetaxel and gemcitabine. Recently, the introduction of trabectedin has provided clinicians with another treatment option, and the drug may have some benefits for patients as it may allow for long-term treatment. We present the case of a patient who previously failed multiple cycles of chemotherapy and who was subsequently treated with 30 cycles of trabectedin as third-line therapy for multiple metastases of uterine leiomyosarcoma...
February 8, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/28170118/image-guided-interstitial-high-dose-rate-brachytherapy-in-the-treatment-of-inoperable-recurrent-head-and-neck-malignancies-an-effective-option-of-reirradiation
#9
Nikolaos Tselis, Efstratios Karagiannis, Christos Kolotas, Mehran Baghi, Natasa Milickovic, Nikolaos Zamboglou
BACKGROUND: In recurrent head and neck cancer, therapeutic options are limited and high-quality evidence is rare. The purpose of this report was to present our experience of CT-guided interstitial high-dose rate (HDR) brachytherapy in 4 challenging cases of inoperable recurrent head and neck cancer. METHODS: A 53-year-old man with mucosal melanoma of the paranasal sinuses, a 61-year-old man with myofibroblastic sarcoma of the nasal cavity, a 51-year-old woman with nasopharyngeal cancer, and a 44-year-old woman with orbital leiomyosarcoma were treated with reirradiation by HDR brachytherapy after previous comprehensive therapy, including full course external radiotherapy (RT)...
February 7, 2017: Head & Neck
https://www.readbyqxmd.com/read/28158190/survival-impact-of-centralization-and-clinical-guidelines-for-soft-tissue-sarcoma-a-prospective-and-exhaustive-population-based-cohort
#10
Olfa Derbel, Pierre Etienne Heudel, Claire Cropet, Pierre Meeus, Gualter Vaz, Pierre Biron, Philippe Cassier, Anne-Valérie Decouvelaere, Dominique Ranchere-Vince, Olivier Collard, Eric De Laroche, Philippe Thiesse, Fadila Farsi, Dominic Cellier, François-Noel Gilly, Jean-Yves Blay, Isabelle Ray-Coquard
PURPOSE: The outcome of sarcoma has been suggested in retrospective and non-exhaustive studies to be better through management by a multidisciplinary team of experts and adherence to clinical practice guidelines (CPGs). The aim of this prospective and exhaustive population based study was to confirm the impact of adherence to CPGs on survival in patients with localized sarcoma. EXPERIMENTAL DESIGN: Between 2005 and 2007, all evaluable adult patients with a newly diagnosis of localized sarcoma located in Rhone Alpes region (n = 634), including 472 cases of soft-tissue sarcoma (STS), were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28140689/the-efficacy-of-trabectedin-in-treating-ovarian-cancer
#11
Eleonora Teplinsky, Thomas J Herzog
The majority of women with epithelial ovarian cancer present with advanced stage disease and there is a critical need for novel drugs and treatment strategies to improve outcomes. Trabectedin is a unique cytotoxic agent with a complex mechanism of action. It binds to guanines in the N2 position in the minor groove of DNA and its cytotoxicity involves DNA repair pathways and transcription regulation. Trabectedin's activity is also related to the drug-induced changes of the tumor microenvironment. It has been shown to improve progression-free survival in combination with pegylated liposomal doxorubicin in patients with platinum-sensitive relapsed ovarian cancer...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28130839/abnormal-p53-and-p16-staining-patterns-distinguish-uterine-leiomyosarcoma-from-inflammatory-myofibroblastic-tumour
#12
Inga-Marie Schaefer, Jason L Hornick, Lynette Marie Sholl, Bradley J Quade, Marisa R Nucci, Carlos Parra-Herran
AIMS: Uterine myxoid leiomyosarcoma may show relatively bland histologic appearances despite its aggressive behaviour. Distinguishing uterine leiomyosarcoma from the more indolent inflammatory myofibroblastic tumour (IMT), which is amenable to targeted therapies, can be challenging. A significant subset of leiomyosarcomas harbour TP53 and/or CDKN2A genomic alterations. Here, we examined the diagnostic value of p53 and p16 immunohistochemistry in the distinction of uterine conventional and myxoid leiomyosarcoma from IMT, in correlation with targeted sequencing of TP53 and CDKN2A...
January 28, 2017: Histopathology
https://www.readbyqxmd.com/read/28128524/uterine-leiomyosarcoma-a-review-of-recent-advances-in-molecular-biology-clinical-management-and-outcome
#13
REVIEW
Rosa R Cui, Jason D Wright, June Y Hou
Uterine leiomyosarcoma (LMS) are rare but aggressive tumors with poor clinical outcomes regardless of stage. Most tumors are identified by histopathology at time of surgery, and pre-operative diagnosis remains a clinical challenge. Management of early-stage LMS relies on surgical resection. Cytotoxic chemotherapy remains the mainstay of therapy for advanced-stage, recurrent, or metastatic LMS, and includes single or combination doxorubicin-, ifosfamide-, or gemcitabine-based regimens. Recent interest in genetic biomarkers led to developments of targeted therapies for LMS, although more research is needed to understand the molecular complexities underlying LMS to guide the development of novel treatment strategies...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28096721/current-concepts-in-non-gastrointestinal-stromal-tumor-soft-tissue-sarcomas-a-primer-for-radiologists
#14
REVIEW
Akshay D Baheti, Jyothi P Jagannathan, Ailbhe O'Neill, Harika Tirumani, Sree Harsha Tirumani
Non-gastrointestinal stromal tumor (GIST) soft tissue sarcomas (STSs) are a heterogeneous group of neoplasms whose classification and management continues to evolve with better understanding of their biologic behavior. The 2013 World Health Organization (WHO) has revised their classification based on new immunohistochemical and cytogenetic data. In this article, we will provide a brief overview of the revised WHO classification of soft tissue tumors, discuss in detail the radiology and management of the two most common adult non-GIST STS, namely liposarcoma and leiomyosarcoma, and review some of the emerging histology-driven targeted therapies in non-GIST STS, focusing on the role of the radiologist...
January 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28094040/a-phase-2-study-of-alisertib-mln8237-in-recurrent-or-persistent-uterine-leiomyosarcoma-an-nrg-oncology-gynecologic-oncology-group-study-0231d
#15
David M Hyman, Michael W Sill, Heather A Lankes, Richard Piekarz, Mark S Shahin, Mildred R Ridgway, Floor Backes, Meaghen E Tenney, Cara A Mathews, James S Hoffman, Carol Aghajanian, Martee L Hensley
OBJECTIVE: This two-stage Phase II study assessed the activity of single agent alisertib in patients with recurrent/persistent uterine leiomyosarcoma (uLMS). METHODS: Eligibility criteria included histologically-confirmed, recurrent or persistent uLMS, age≥18, 1-2 prior cytotoxic regimens, and RECIST version 1.1 measurable disease. The primary objective of the study was to evaluate the efficacy of alisertib through the frequency of patients with objective tumor responses and the frequency who survived event-free for at least 6months (EFS6)...
January 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#16
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28007271/biatrial-high-grade-leiomyosarcoma-with-nine-year-post-surgical-survival
#17
Lakshmi Muthukumar, M Fuad Jan, Robert Taylor, John Crouch, Gary Neitzel, A Jamil Tajik
Primary cardiac leiomyosarcoma is a rare tumor with poor prognosis. We present a 53-year-old female patient with biatrial leiomyosarcoma with inferior vena cava and coronary sinus involvement who underwent aggressive surgical resection with reconstruction of her left and right atrium and coronary sinus with bovine pericardium followed by adjuvant radiation therapy. She is living well with no recurrence 9 years after diagnosis.
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27955634/transdifferentiation-of-pancreatic-stromal-tumor-into-leiomyosarcoma-with-metastases-to-liver-and-peritoneum-a-case-report
#18
Chao Lin, Liping Wang, Jiyao Sheng, Dan Zhang, Lianyue Guan, Kai Zhao, Xuewen Zhang
BACKGROUND: Primary pancreatic leiomyosarcoma is a rare pancreatic malignancy; the clinical presentation and treatment is not well-characterized. Further, the molecular mechanisms underlying its pathogenesis are not known. We report a patient with pancreatic stromal tumor that progressed to primary pancreatic leiomyosarcoma with hepatic and peritoneal metastases. CASE PRESENTATION: A 54-year-old woman was found to have pancreatic and hepatic tumor masses on routine health checkup...
December 13, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27918201/the-importance-of-treating-by-histological-subtype-in-advanced-soft-tissue-sarcoma
#19
REVIEW
Javier Martín Broto, Axel Le Cesne, Peter Reichardt
While surgical resection (±radiotherapy) is standard treatment for localized soft tissue sarcomas (STS), chemotherapy is the mainstay for managing locally advanced and metastatic disease. Expanding knowledge of the biologies and sensitivities of STS histotypes, in conjunction with results from a growing collection of retrospective reviews and prospective randomized studies, point to the importance of treating in consideration of histological subtype. Doxorubicin ± ifosfamide continues to be standard first-line therapy for most STS subtypes...
January 2017: Future Oncology
https://www.readbyqxmd.com/read/27882721/survival-of-patients-with-metastatic-leiomyosarcoma-the-md-anderson-clinical-center-for-targeted-therapy-experience
#20
Zhijie Wang, Naiyi Shi, Aung Naing, Filip Janku, Vivek Subbiah, Dejka M Araujo, Shreyaskumar R Patel, Joseph A Ludwig, Lois M Ramondetta, Charles F Levenback, Pedro T Ramirez, Sarina A Piha-Paul, David Hong, Daniel D Karp, Apostolia M Tsimberidou, Funda Meric-Bernstam, Siqing Fu
Advanced stage leiomyosarcoma (LMS) is incurable with current systemic antitumor therapies. Therefore, there is clinical interest in exploring novel therapeutic regimens to treat LMS. We reviewed the medical records of 75 consecutive patients with histologically confirmed metastatic LMS, who had been referred to the Clinical Center for Targeted Therapy at MD Anderson Cancer Center. To lay the foundation for potential phase I trials for the treatment of advanced LMS, we analyzed tumor response and survival outcome data...
December 2016: Cancer Medicine
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