Multidisciplinary Treatment of Advanced Soft Tissue Sarcomas - Episode 1

Incidence and Subtypes of Advanced Soft Tissue Sarcoma


Brian A. Van Tine, MD, PhD: Hello, and thank you for joining us for this OncLive TV Peer Exchange. This program will feature an expert panel discussion focused on the treatment of advanced soft tissue sarcoma through a multidisciplinary approach. I am Dr. Brian Van Tine, and I am a medical oncologist. I’m also an assistant professor of medicine and the Sarcoma Program director at Washington University in St. Louis at the Siteman Cancer Center, which is also at Barnes-Jewish Hospital.

Joining me today is an exceptional panel of world leaders in the treatment of sarcoma.

The first is Dr. Robin Jones who’s a medical consultant at the Royal Marsden Hospital at the Institute of Cancer Research in London.

Next joining me is Dr. Shreyaskumar Patel, the Robert R. Herring Distinguished Professor of Medicine, the medical director of the Sarcoma Center, and deputy chairman for the Department of Sarcoma Medical Oncology, all at the University of Texas MD Anderson Cancer Center.

Next is Dr. Lor Randall who’s the LB and Olive S. Young Endowed Chair for Cancer Research, director of Sarcoma Services, and the medical director of Surgical Services—all at the Huntsman Cancer Institute at the University of Utah.

Next is Dr. Jonathan Trent who’s an associate director for clinical research and the director of the Sarcoma Medical Research Program at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

Dr. Andrew Wagner is also joining us today. He is an assistant professor of medicine at the Harvard Medical School and the senior physician of Adult Oncology in the Center for Sarcoma and Bone Oncology at the Dana Farber Cancer Institute.

Thank you for joining us today. I’d like to begin by discussing soft tissue sarcomas: how they are diagnosed and how they are classified.

Dr. Patel, if you could begin by educating us a little bit about the prevalence of soft tissue sarcomas and maybe add a little bit of a discussion of the common subtypes.

Shreyaskumar R. Patel, MD: This is a very rare group of tumors. It’s important for our audience to realize that sarcomas are groups of diseases rather than 1 disease. They are rare in the sense that of the 1,650,000-plus cancers diagnosed in the United States in a calendar year, there are a little less than 12,000 that are soft tissue sarcomas, as predicted by the American Cancer Society. There have been questions related to whether this incidence is appropriate and correct or not, but these are the best numbers that we have.

As for prevalence, it’s a much harder number to come by. We don’t even know how we would define prevalence. For instance, for somebody who had a tumor that was resected and is currently free of disease, does that person count or not? So, the prevalence is a much harder number to come by, but the incidence is under 12,000 a year.

There are at least 50-plus subtypes of soft tissue sarcomas. Many of these have individual characteristics, where they behave differently from a biologic standpoint; there can be therapeutic considerations that we will be talking about throughout the next hour and a half.

Brian A. Van Tine, MD, PhD: What are the more common subtypes?

Transcript Edited for Clarity

Shreyaskumar R. Patel, MD: If you look at most of the registry data, the top 3 or 4 common subtypes would include leiomyosarcoma and liposarcoma, which is actually a mixed bag of about 4 or 5 different subtypes that include adipocytic sarcomas or liposarcomas. Then there are undifferentiated pleomorphic sarcomas (aka fibrocysteal sarcoma). The nondescript spindle cell sarcoma that does not have any specific differentiation would be the third most common. Then there is a variety of others that are reported as synovial sarcomas, angiosarcomas, and rhabdomyosarcomas, etc.