Expanding Sarcoma Treatment Options

Dr. Brenda Weigel

Dr. Brenda Weigel, review contributor

“Deeper understanding of disease biology may expand sarcoma treatment options” - HemOnc Today, July 10, 2017

That’s the title of a good up-to-date review of sarcoma. There are over 50 major types of sarcoma. Some of these sarcoma types don’t have many subtypes, an example is synovial sarcoma, and some have many, for example osteosarcoma. Researchers found over 60,000 mutations when checking the DNA in 107 patients. Most of these mutations don’t have a role in cancer, some are just a part of growing up. Sixty of the 107 patients had mutations that could be treated, what these researchers called actionable. Most of the treatments are not cure, or disappearance of the tumor, just slowing of growth.

Ewing’s sarcoma has a translocation in the chromosomes. That is relatively easy to find, yet treatment for this “obvious” abnormality has so far proven disappointing. Many sarcomas don’t have readily findable markers in testing the DNA, making it a challenge to treat some of these cancers.

Dr. Brenda Weigel of the U of Minnesota commented that treating these cancers when they recur is especially difficult. She stated; “Over the last decade we have gained a much greater understanding of some of the biology that is relevant to different types of sarcomas, but it has also shown us that we know very little.” Olaratumab is a new drug that has shown some help in phase two studies, and that is encouraging, the first drug to show benefit in osteosarcoma in the advanced disease situation. The contemplated phase 3 study will evaluate the drug in a larger population. Not yet ready for general use.

Erybulin mesylate was approved by the FDA in 2016 and is the first drug to show benefit in liposarcoma. In 2015 Yondelis (trabectidin) was approved and was the first approved treatment for liposarcoma and leiomyosarcoma in 30 years!

So much research is being done into the biology of cancer, and also sarcoma, worldwide. Examining the deep abnormalities in the genetics of cancer has opened new doors and stimulated the work toward new drugs. It is hopeful.

Larry Seymour, MD

RIS Board Member

Link to the referenced article in HemOnc Today, July 10, 2017