Personalised pharmacotherapy options for soft tissue sarcomas

ABSTRACT Introduction Soft tissue sarcomas (STS) are a rare and heterogeneous group of tumors. The role of molecular testing to inform diagnosis, disease prognosis, and therapy has become critical to optimal treatment. Areas covered This review reports updated data on precision therapy in patients with STS, particularly those of immediate utility in clinical practice. Expert opinion There is a high unmet need for effective systemic therapy for patients with STS. In the era of precision medicine, doxorubicin-based chemotherapy is still the standard of care in first-line treatment for the majority of histologic subtypes with a median overall survival of only 20 months. Precision therapy for STS has only been partially effective. A new wave of targeted therapeutic agents has been approved with preferential benefit in subgroups of patients. Immunotherapy is now undergoing clinical trials. There is a heterogeneity in the benefit of immune checkpoint inhibitors across subtypes. Strategies targeted to antigen bearing sarcomas including vaccine and adoptive T-cell have yielded promising results in selected histotypes.