S14 Ep8: Recent FDA Approvals and Ongoing Research Expand Treatment Options for Soft Tissue Sarcoma: With Samantha A. Armstrong, MD; and Karine Tawagi, MD
Two Onc Docs, hosted by Samantha A. Armstrong, MD, and Karine Tawagi, MD, is a podcast dedicated to providing current and future oncologists and hematologists with the knowledge they need to ace their boards and deliver quality patient care. Dr Armstrong is a hematologist/oncologist and assistant professor of clinical medicine at Indiana University Health in Indianapolis. Dr Tawagi is a hematologist/oncologist and assistant professor of clinical medicine at the University of Illinois in Chicago.
In this episode, OncLive On Air® partnered with Two Onc Docs to feature a conversation about soft tissue sarcoma management. Drs Armstrong and Tawagi discussed that soft tissue sarcomas represent a rare and heterogeneous group of malignancies that arise from mesenchymal cells rather than epithelial cells and encompass several distinct histologic subtypes. They explained that although uncommon, these sarcomas are frequently emphasized in board examinations, partly because their management has historically been stable, though recent FDA approvals and ongoing research have expanded therapeutic options.
They noted that risk factors may include prior radiation exposure, environmental agents, and viral infections. Additionally, they shared that chronic lymphedema is associated with angiosarcoma, whereas rare hereditary syndromes may predispose individuals to specific sarcoma subtypes.
Clinically, they explained that sarcomas may arise anywhere in the body, though many occur in the thigh, buttocks, or groin, typically presenting as painless, enlarging masses often mistaken for benign lesions. They emphasized that diagnosis requires core needle biopsy to preserve tissue architecture and that staging relies on MRI of the primary site and CT of the chest, given the strong predilection for pulmonary metastases. They also summarized the five subtypes of soft tissue sarcoma—synovial, clear cell, angiosarcoma, rhabdomyosarcoma, and epithelioid.
They reported that the cornerstone of localized disease management is surgical resection, preferably limb-sparing when feasible, combined with radiation for larger or high-risk tumors. They also highlighted novel strategies like immunotherapy. For metastatic disease, they stated that surgical resection of pulmonary metastases can achieve durable remissions in select patients.
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