Dr. Schlumbrecht on Traditional Treatment Approaches for Uterine Leiomyosarcoma

Matthew P. Schlumbrecht, MD, associate professor and co-director of Cancer Prevention and Control, Division of Gynecologic Oncology, University of Miami Sylvester Comprehensive Cancer Center, discusses the traditional treatment approaches for patients with uterine leiomyosarcoma.

For all cancer types, Schulbrecht says, researchers are trying to understand the role of traditional approaches, such as chemotherapy, radiation, and hormone antagonism, in the current treatment paradigm. In the general landscape of sarcomas, surgical resection is a mainstay of treatment, whether it be for primary diagnosis or for oligometastatic disease. In terms of radiation, negative data from the 1980s showed no improvement in progression-free survival (PFS) or overall survival with this approach; however, pelvic radiation has been found to reduce risk of recurrence in the pelvis.

Chemotherapy, however, has played a critical role in the management of this disease since the 1960s, Schlumbrecht says, both in the form of a single agent and used in combination with other drugs. The advent of targeted therapies has also opened the door to several new options for patients. Pazopanib (Votrient) and trabectedin (Yondelis) have shown modest activity in clinical trials, but the aggressive nature of the tumor limits PFS benefit to 3 or 4 months.