Systemic therapy of soft tissue sarcomas – “nothing new under the sun?” – ASCO 2009

The systemic treatment of patients with soft tissue sarcomas is an area of controversies where small progress has been made over the past years. The rarity of the disease in addition to the huge diversity of subtypes is probably to be responsible for the sometimes conflicting data obtained in clinical trials. Data presented on this year’s ASCO meeting dealt with the benefit from adjuvant treatment and with the concept of highdose consolidation therapy after complete surgical resection of a metastatic disease. The results of these trials lend support to the notion that systemic adjuvant treatment requires a rigorous patient selection and that dose escalation does not confer to a survival benefit in a situation of minimal residual disease. The more detailed understanding of pathognomonic alterations in sarcomas initiated early clinical trials with molecular directed therapies, which will probably invigorate our therapeutical possibilities.