Sarcoma: Targeted agents and multi-modal approaches are improving outcomes and transforming care
The sarcoma treatment landscape is changing quickly and dramatically, with a growing number of FDA-approved drugs and clinical trials offering new hope and improving outcomes for patients whose treatment options were very limited just a few years ago.
Medical oncologist Michael Wagner, MD, and radiation oncologist Stephanie Schaub, MD are sarcoma experts who treat patients at Seattle Cancer Care Alliance (SCCA). They recently joined the Oncology Sound Byte podcast to deliver an update on the latest sarcoma approaches.
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“We’re seeing more and more targeted agents for specific sarcoma subtypes, we’re offering access to many promising clinical trials, and we’re finding intriguing results in trials that combine immunotherapy with standard of care,” Dr. Wagner says.
SCCA is the Northwest’s largest sarcoma referral center and offers one of the nation’s most comprehensive portfolios of sarcoma clinical trials, in partnership with Fred Hutchinson Cancer Research Center and UW Medicine. These include a study that adds a checkpoint inhibitor, pembrolizumab, to standard care with five weeks of radiation followed by surgical resection.
“We’re learning that certain immunotherapies can have good activity against particular sarcoma subtypes,” Dr. Wagner says. “We’re hopeful that these therapies will increase the radiation’s effectiveness and long-term benefit, and potentially reduce the likelihood of recurrence.”
Dr. Wagner and Dr. Schaub recommend referring patients as soon as they’re diagnosed with sarcoma. This enables the team to quickly evaluate their cancer and explore potential clinical trials. SCCA offers telehealth consultations and coordinates in-person multi-disciplinary appointments, during which patients see an orthopedic surgeon, surgical oncologist, radiation oncologist and medical oncologist on the same visit.
“By the end of the day, they’ll be able to leave with a well-formulated treatment plan that’s tailored to them,” Dr. Schaub says. If it’s too hard for a patient to travel to Seattle for treatment, the team will work closely with a patient’s community physician to guide treatment.
Patients treated at SCCA have access to precise radiation modalities that enable radiation oncologists to reduce impact on neighboring tissue and minimize long-term toxicity. Dr. Schaub and her colleagues can use their experience with sarcoma and other hard-to-treat cancers to design precise radiation fields and, if appropriate, match the patient with proton therapy.
“We’ve found this approach to be incredibly helpful for tumors in challenging areas to treat, such as the spine or pelvis, and we have even reported patients that have gone on to have children and maintain their fertility,” Dr. Schaub says.
It’s all part of SCCA’s commitment to using innovative approaches to transform care for sarcoma and many other cancers.
“It’s an incredibly exciting time to be treating sarcoma – we’re seeing these new multi-modality approaches help some patients live longer, with a better quality of life, and I think that’s just going to keep getting better over time,” Dr. Schaub says.
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