Neoadjuvant chemotherapy in localised soft-tissue sarcomas: where do we go from here?

Abstract

In The Lancet Oncology, Alessandro Gronchi and colleagues report a phase 3 trial 1 Gronchi A Ferrari S Quagliuolo V et al. Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001): an international, open-label, randomised, controlled, phase 3, multicentre trial. Lancet Oncol. 2017; 18: 812-822 Summary Full Text Full Text PDF PubMed Scopus (292) Google Scholar randomly assigning 287 patients with localised, high-risk extremity and trunk wall soft-tissue sarcomas to receive three cycles of histotype-tailored chemotherapy versus a standard control of full-dose chemotherapy with epirubicin plus ifosfamide. With a median follow-up of 12·3 months (IQR 2·75–28·20), the trial was closed prematurely after the third interim analysis for futility because superiority for the histotype-tailored chemotherapy group was not to be expected for both the primary endpoint disease-free survival and the secondary endpoint overall survival. Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001): an international, open-label, randomised, controlled, phase 3, multicentre trialIn a population of patients with high-risk soft-tissue sarcoma, we did not show any benefit of a neoadjuvant histotype-tailored chemotherapy regimen over the standard chemotherapy regimen. The benefit seen with the standard chemotherapy regimen suggests that this benefit might be the added value of neoadjuvant chemotherapy itself in patients with high-risk soft-tissue sarcoma. Full-Text PDF