Soft tissue sarcoma research | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter

Soft tissue sarcoma research

Men and woman discussing soft tissue sarcomas

This page of the soft tissue sarcoma section is about research into soft tissue sarcoma treatment. You can find information about

 

A quick guide to what's on this page

Soft tissue sarcoma research

All treatments must be fully researched before they can be adopted as standard treatment for everyone. This is so that we can be sure they work better than the treatments we already use. We also need to know that they are safe.

First of all, treatments are developed and tested in laboratories. Only after we know that they are likely to be safe are they tested in people, in clinical trials. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

Researchers are looking into

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating soft tissue sarcoma section.

 

 

Why we need research

All new potential treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that

  • We can be sure they work
  • We can be sure they work better than the treatments that are available at the moment
  • We know they are safe
 

The research process

First of all, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.

Tests of treatments on patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials.

There is information about the 4 phases of clinical trials in the trials and research section. In that section you can also visit our searchable database of clinical trials for soft tissue sarcoma. If there is a trial you are interested in, you can print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to refer you to the research team. The database also has information about closed trials and trial results.

Everything covered on this page is the subject of ongoing research. Until studies are completed and new effective treatments are found, these experimental treatments cannot be used as standard therapy for soft tissue sarcomas.

Here is a video on experiences of taking part in a clinical trial:

View a transcript of the video (Opens in a new window) 

 

Understanding sarcoma cells

Cancer researchers study both normal and cancer cells so that they can find out more about the disease and what goes wrong within the cell. This research aims to find the causes of soft tissue sarcomas at cell level. Doctors and researchers also look at response to treatment and how the genes in the sarcoma cells may affect that. 

Some genes can predict how the cancer will respond to chemotherapy. These genes are called multi-drug resistance (mdr) genes. Doctors may be able to use this information in the future to choose treatments for people with sarcoma, according to how their cancer is likely to respond.

 

Tests for sarcoma

Some people have a soft tissue sarcoma affecting the soft tissues behind the organs in their tummy (abdomen). Doctors call this type of sarcoma a retroperitoneal sarcoma. You may have surgery to remove it, and you may also have radiotherapy to shrink the cancer before surgery. Doctors usually use CT scans to plan treatment. The PIRS study is looking at a different type of MRI scan to help plan treatment for retroperitoneal sarcoma. In this study, researchers want to see if a type of MRI scan called functional MRI (fMRI) gives them more information. These scans can show what is happening inside the cancer, rather than simply its structure.

 

Chemotherapy

Doxorubicin and ifosfamide are the most commonly used chemotherapy drugs for soft tissue sarcoma. Doctors around the world are supporting research in hospitals and clinics to improve existing treatments. They are studying different combinations of chemotherapy drugs, different doses, or giving the drugs in different sequences. The aim of this type of research is to find better ways of treating sarcomas with chemotherapy.

Over the past few years trabectedin (Yondelis) has been licensed in Europe. It is for people with advanced soft tissue sarcoma that has not responded to, or has come back after, chemotherapy with ifosfamide and anthracyclines such as doxorubicin. Yondelis is a chemotherapy drug that was developed from sea squirts. It is now approved by the National Institute for Health and Care Excellence (NICE) for use in the NHS in England and Wales. But it is not approved by the Scottish Medicines Consortium (SMC) for use in Scotland because they say it is not cost effective.

Ewing's sarcomas can occur in bone or in soft tissue. Their treatment and outcomes are different to other types of soft tissue sarcoma.  The EURO-EWING 99 trial is looking into different combinations of chemotherapy for Ewing's tumours and PNET. This trial has closed and we are waiting for the results. There is now the Euro Ewing 2012 trial which is comparing different combinations of chemotherapy before and after surgery. 

There is a trial looking at treatment for children and young people with rhabdomyosarcoma. It is using different combinations of chemotherapy before or after surgery (or both), with or without radiotherapy. Another trial is looking at the same treatment options for children and young people with other types of soft tissue sarcoma.

The GeDDIS trial is looking at having either doxorubicin, or a combination of 2 drugs called docetaxel (Taxotere) and gemcitabine (Gemzar), as a first treatment for sarcoma that has spread into surrounding body tissue, or to other parts of the body. Children over the age of 13 as well as adults are taking part. The aims of the trial are to find out if this combination of drugs works better than the standard treatment for soft tissue sarcoma that has spread. It also wants to learn more about the side effects. This trial has now closed and we are waiting for the results. 

A type of sarcoma called leiomyosarcoma can grow in the womb. You usually have your womb removed for this type of cancer and you are closely followed up afterwards to check for signs of the cancer coming back. A trial is comparing chemotherapy with no further treatment after surgery to remove sarcoma of the womb. In this trial, researchers want to see if having chemotherapy drugs after surgery to remove leiomyosarcoma reduces the chance of the cancer coming back. 

The EORTC-1202 trial is comparing cabazitaxel chemotherapy with ifosfamide for liposarcoma that has spread to other parts of the body or can't be removed with surgery.

One trial is looking at temozolomide for rhabdomyosarcoma. Doctors can treat rhabdomyosarcoma that has not responded to treatment or has come back with the chemotherapy drugs vincristine and irinotecan. Temozolomide is a chemotherapy tablet that doctors use to treat some other types of cancer. Doctors in this trial want to see if adding temozolomide to vincristine and irinotecan helps people with rhabdomyosarcoma. This trial has now closed and we are waiting for the results.

Another trial is comparing the chemotherapy drugs eribulin and dacarbazine for people with soft tissue sarcoma. Doctors want to see if eribulin can help people with sarcoma that has come back after treatment (recurred). They want to see if it is better than the standard treatment of dacarbazine. This trial has now closed and we are waiting for the results. 

You can find out more about chemotherapy trials for soft tissue sarcoma on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Blood tests to monitor treatment

Cancers are made up of cells that grow and multiply quickly. They do this because they have a number of mistakes called mutations in their DNA. The gene changes are called a genetic signature. If there is a sarcoma in the body, small numbers of cells with the genetic signature can be found in the blood. Each person has a different genetic signature. 

The BODIS study is trying to find out if it is possible to use a blood test to monitor people with sarcoma, by looking for the faulty tumour DNA signature. They hope that the test can help them to know how well treatment is working or when a sarcoma has come back.

 

Radiotherapy

There is research into

  • Radiotherapy for advanced sarcomas (palliative radiotherapy)
  • Radiotherapy to help stop sarcomas coming back after surgery (neo adjuvant or adjuvant radiotherapy)
  • Improving the doses we use and the area treated
  • Internal radiotherapy

Cancer Research UK is supporting the VORTEX trial that is looking into using different doses of radiotherapy after surgery for soft tissue sarcoma. Doctors want to give enough treatment to control the cancer. But they don't want to give too high a dose as this could cause unnecessary side effects. The VORTEX trial has now closed and we are waiting for results.

 Another trial looked into radiotherapy for aggressive fibromatosis (desmoid tumour) that can't be removed with surgery, or has come back. The trial team concluded that radiotherapy worked well for people with desmoid tumours.

The STRASS trial is comparing radiotherapy and surgery to surgery alone in people with soft tissue sarcoma in the area between the hip bones (pelvis). This is called retroperitoneal sarcoma. Researchers want to see if giving radiotherapy before surgery helps stop the sarcoma coming back.

New ways of giving radiotherapy may be developed for sarcoma. Internal radiotherapy (brachytherapy) is being studied in clinical trials for some types of cancers and has been used to treat sarcoma. Brachytherapy involves having radioactive seeds or wires implanted into the cancer or into the area where the cancer was (after surgery). The advantage of this type of treatment is that it gives a very high dose of radiation to the area of the tumour, but a much lower dose to the surrounding area than external radiotherapy.

Brachytherapy could be useful for treating people who have already had radiotherapy and have some cancer left behind. It could also help if people have cancer that comes back in the same place some time after their radiotherapy. We are a very long way from knowing how well this will work in sarcoma. But we have mentioned it here because it is something we are asked about.

 

Biological therapies

Biological therapies are treatments that change chemical processes in cells or change the way that cells signal to each other. There are a number of different types of biological therapy, including cancer growth blockers and drugs that stop cancer blood vessel growth.

Some types of biological therapy that block the substances cells use to signal to one another to grow are being tested for some types of sarcoma. They are called tyrosine kinase inhibitors (TKIs) and include imatinib (Glivec) and axitinib (Inlyta). Other newer types of growth blockers include deforolimus and pazopanib (Votrient).

Imatinib (Glivec)

Imatinib (Glivec) is a tyrosine kinase inhibitor. It is licensed in the UK to treat a particular type of sarcoma called gastro intestinal stromal tumour (GIST). These most often grow in the stomach, but can be found anywhere along the gut. The National Institute for Health and Care Excellence (NICE) recommends imatinib as a first treatment in the UK if you have GIST that has spread or cannot be completely removed with surgery. It can also help to treat a slow growing, low grade type of sarcoma called dermatofibrosarcoma protruberans (DFSP)

One advantage of this treatment is that it comes as a tablet so you can have treatment at home. There is detailed information about imatinib in our cancer drugs section. You can find information about imatinib treatment for GIST on our page about biological therapies and soft tissue sarcoma.

The EORTC 62024 trial looked into using imatinib after surgery for GIST. Having a treatment after surgery to try to stop cancer coming back is called adjuvant therapy. Around 900 people took part in the trial. Half the people had imatinib after surgery and the other half had no further treatment. The trial team found that in the first few years after surgery, GIST came back in fewer people who had imatinib. They also found that more than 1 in 6 people (17%) who took imatinib stopped the treatment because of side effects or because they didn't want to carry on taking it. An American trial has also looked into adjuvant therapy and found that in people who took imatinib after surgery, their GIST was kept under control for longer than for people not taking it.

In 2010, the Scottish Medicines Consortium (SMC) recommended that imatinib should be available on the NHS in Scotland for GIST after surgery. It is only for people who have a high risk of their tumour coming back. In 2014, the National Institute for Health and Care Excellence (NICE) also approved it for this use in England and Wales.

Masitinib

Masitinib is another tyrosine kinase inhibitor (TKI). A trial is comparing masitinib with imatinib as the first drug treatment for gastrointestinal stromal tumours (GISTs) that can't be removed with surgery, or have spread to other parts of the body. The aims of this trial are to see if masitinib is better than imatinib in this situation, and to learn more about the side effects.

Another trial is comparing masitinib and sunitinib for GIST that has spread to another part of the body or can't be removed with surgery. Sunitinib is another type of TKI. The researchers want to find out which of the 2 drugs is better for GISTs that have got worse despite having imatinib, and to learn more about the side effects.

Axitinib (Inlyta)

The Axi-STS trial is looking at a new tyrosine kinase inhibitor called axitinib for soft tissue sarcoma that has spread to the lymph nodes (is locally advanced) or to any other organs of the body. This trial has now closed and we are waiting for the results.

Deforolimus

Deforolimus stops a protein called mTOR from working properly. mTOR is important because it controls other proteins that are needed for cells to grow. So if mTOR can't work, then neither can these other proteins. This may help to slow down or stop a cancer growing. The SUCCEED trial found that deforolimus helped control sarcoma in people who had already had chemotherapy. You can read a summary of the results of the SUCCEED trial on our clinical trials database.

Pazopanib

Pazopanib (Votrient) is a type of drug known as a multi tyrosine kinase inhibitor. It blocks signals that make cancer cells grow. It also stops the cancer being able to make it's own blood supply. This is called anti angiogenesis. Cancers need their own blood vessels to get bigger. Without a blood supply the cancer cannot continue to grow. The All Wales Medicines Strategy Group recommend pazopanib should be an option for people who have had chemotherapy for soft tissue sarcoma that has spread or for people whose cancer has come back within 12 months of chemotherapy that they had before their surgery. NICE have not assessed pazopanib for use within the NHS in England. The Scottish medicines consortium did not recommend it as a treatment within the NHS in Scotland.

The EORTC 62043 trial looked at pazopanib for people with soft tissue sarcoma that continued to grow despite treatment. The trial results are now available and the researchers found that pazopanib was a useful treatment for soft tissue sarcoma and that the side effects were not too bad. 

A larger trial called PALETTE compared pazopanib tablets with a dummy drug (placebo) in people with soft tissue sarcoma that had spread and grown or come back despite other treatment. The results of this trial showed that people who took pazopanib had on average 3 months longer before their cancer started to grow than those who took the placebo. There is more information about pazopanib (Votrient) and its side effects in the cancer drug section.

Bevacizumab

Bevacizumab (Avastin) is a type of monocloncal antibody. The BERNIE trial is comparing bevacizumab and chemotherapy with chemotherapy alone for children and teenagers with soft tissue sarcoma that has spread. This trial has now closed and we are waiting for the results.

Selumetinib

The SCART trial is looking at selumetinib for people with Kaposi’s sarcoma. Kaposi's sarcoma is a rare type of cancer which can affect people with HIV. In this trial, doctors want to give people with Kaposi’s sarcoma a drug called selumetinib, provided they are also having treatment for HIV. Selumetinib is a type of biological therapy called a MEK inhibitor.

Cediranib

Cediranib is a new type of biological therapy. It blocks the cancer from developing its own blood supply and this may help to slow or stop cancer growth. It is called an anti angiogenic drug.  The CASPS trial is looking at cediranib for alveolar soft part sarcoma (CASPS).  Alveolar soft part sarcoma (ASPS) is a rare type of soft tissue sarcoma. The researchers want to find out if this drug helps people with this type of sarcoma. 

You can find details of these trials for soft tissue sarcoma on our clinical trials database

Children's impact statement - Soft tissue sarcoma

Rate this page:
Submit rating
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 27 February 2015