A Hard Look at Soft Cancers

Soft tissue sarcoma chemotherapy evaluation

(RxWiki News) Sometimes when you go to the doctor, you wonder - how do they keep up with all the recent research and treatment options for all of this stuff? How do they know how chemotherapies stack up against each other?

Faced with little data on a rare cancer, an surgeon specializing in soft tissue sarcomas, a fairly rare cancer, has published a predictive chart to help oncologists understand all of the treatment options.

Although soft tissue sarcomas are rare, some are completely unaffected by standard treatments. 

In the first step of establishing better care for these rare cancers, researchers used data from three major studies on soft tissue sarcomas to create a statistical chart called a nomogram that give doctors a more complete picture of survival timelines.

"Ask your oncologist about nomograms."

Alessandro Gronchi, MD, is surgical oncologist specializing in soft tissue sarcomas and was the lead author of the study, due to his desire for a better scientific standard for treatments in soft tissue sarcoma. Dr. Gronchi recently presented his conclusions at the annual meeting of the American Society of Clinical Oncology.

Publishing solid data on this cancer is important for doctors not only because of how little documented information is available, but the rare nature of the cancer may also mean they have not seen similar cases during training.

Expert guidelines backed up by solid evidence could be key for patients that have rare cancers.

As head of the sarcoma service in Milan's Istituto Nazionale Tumori, Dr. Gronchi has to continually make decisions about the best treatment for patients.

He has to find just the right mix in the number of chemotherapy cycles, timing of surgery and drugs chosen, balancing the need to eradicate the cancer against the heavy toll the treatments can take on patients.

As demonstrated in his 2009 report on chemotherapy in soft tissue sarcomas, the contrast of many soft tissue tumors in adults that are seemingly immune to chemotherapy is striking when compared to the the same cancers in children.

The introduction of chemotherapy in the 1970s to treat soft tissue cancers in childhood changed survival rates from 20 to 60 percent in the first decade of testing.

Some specific varieties of soft tissue sarcomas in adults have shown tantalizing responses to certain drugs, like synovial sarcomas and Mitoxana or Ifex (ifosfamide), or the use of Gleevec (imatinib) in treating dermatofibrosarcoma protuberans. But the relatively rare nature of these tumors in adults makes effective testing difficult.

Analysis of the three studies, which followed 526 patients over a ten-year period, allowed researchers to create a single mathematical model with all the data in its proper context.

This information, called a nomogram, will partly allow the conclusions of future studies to have more statistical power.

Doctors may now use the nomogram for their soft tissue cancer patients, taking into account several prediction factors such as the demographics of the patients, qualities of the tumor and treatment.

On average, the nomogram showed that the 5-year survival rates for the 526 patients were projected to be 56 percent, and 7-year survival rates at around 50 percent.

Studies presented at conferences should be considered preliminary until published in a peer-reviewed journal. No financial conflicts of interest were disclosed by the researchers.

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Review Date: 
June 15, 2012