Pharmacotherapy for liposarcoma: current state of the art and emerging systemic treatments

Expert Opin Pharmacother. 2019 Aug;20(12):1503-1515. doi: 10.1080/14656566.2019.1618271. Epub 2019 May 28.

Abstract

Introduction: Liposarcomas are a heterogeneous group of soft tissue tumors that arise from adipose tissue and are one of the most common soft tissue sarcomas found in adults. Liposarcomas are subclassified into four subtypes with distinct histologic and biologic features that influence their treatment and management. Areas covered: This manuscript reviews the key clinicopathologic and cytogenic characteristics of the liposarcoma histologic subtypes and summarizes the results of recent clinical trials, treatment options, and future directions in the pharmacotherapy for the management of liposarcoma. Expert opinion: Despite significant advancements in the management of this disease, the treatment of liposarcoma continues to be a challenge. Surgical resection remains the mainstay of treatment for localized disease; however, use of systemic therapies in conjunction with surgery may be considered in patients where tumor shrinkage could reduce surgical morbidity and in patients with high-risk of micrometastatic disease. Anthracycline-based chemotherapy regimens remain the standard first-line treatment for unresectable/metastatic liposarcoma. Trabectedin and eribulin are currently the two most promising and evidenced-based second-line treatment options for liposarcomas. However, multiple clinical trials dedicated to patients with liposarcoma evaluating novel targeted agents are ongoing. Every effort should be made to enroll patients with liposarcoma into histotype-specific clinical trials.

Keywords: Cytotoxic Chemotherapy; liposarcoma; myxoid/round cell; pleomorphic; targeted therapy; well-/dedifferentiated.

Publication types

  • Review

MeSH terms

  • Adult
  • Anthracyclines / therapeutic use
  • Antineoplastic Agents / classification*
  • Antineoplastic Agents / therapeutic use*
  • Drug Discovery / methods
  • Drug Discovery / trends
  • Drugs, Investigational / therapeutic use*
  • Furans / therapeutic use
  • Humans
  • Ketones / therapeutic use
  • Liposarcoma / drug therapy*
  • Liposarcoma / epidemiology
  • Liposarcoma / pathology
  • Sarcoma / drug therapy
  • Sarcoma / epidemiology
  • Sarcoma / pathology
  • Soft Tissue Neoplasms / drug therapy*
  • Soft Tissue Neoplasms / epidemiology
  • Soft Tissue Neoplasms / pathology
  • Trabectedin / therapeutic use

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Drugs, Investigational
  • Furans
  • Ketones
  • Trabectedin
  • eribulin