The role of adjuvant therapy in uterine leiomyosarcoma
The overall effectiveness of the currently available systemic treatments is still poor.
Uterine leiomyosarcoma (uLMS) is a rare and aggressive mesenchymal tumor of the gynecologic tract that accounts for 1–3% of uterine cancers but the majority of uterine cancer–related deaths. Standard treatment involves total hysterectomy and bilateral salpingo‑oophorectomy; however, the role of adjuvant systemic or radiation therapy remains undefined. This review summarizes randomized trials, phase II/III studies, and observational data evaluating chemotherapy (doxorubicin, gemcitabine plus docetaxel, ifosfamide, API combinations), targeted agents (pazopanib, trabectedin, mTOR inhibitors), and radiotherapy. Across all studies, no adjuvant regimen has demonstrated a statistically significant improvement in overall survival, underscoring an unmet therapeutic need.
Because uLMS is associated with high recurrence rates and dismal survival for advanced disease, identifying effective adjuvant treatments could significantly improve patient outcomes and reduce mortality.
Bizonyítékszint: Megerősített klinikai bizonyíték. Több vagy erősebb humán vizsgálat támogatja.
Kapcsolódó jelek
- First-Line Chemotherapy Regimens for Advanced and Metastatic Leiomyosarcoma: Doxorubicin vs. Gemcitabine—A Systematic Review
- Leiomyosarcoma
- Eribulin versus dacarbazine in patients with leiomyosarcoma: subgroup analysis from a phase 3, open-label, randomised study
- Lineage-defined leiomyosarcoma subtypes emerge years before diagnosis and determine patient survival
- Immunotherapy-based salvage therapy in advanced soft tissue sarcoma after first-line chemotherapy: a retrospective single-center analysis with emphasis on undifferentiated pleomorphic sarcoma