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9 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Synovial sarcoma is a young person's sarcoma driven by a single fusion gene, SS18-SSX, that scrambles how genes are switched on. It is treated with surgery, radiotherapy and ifosfamide-based chemotherapy, and in 2024 it became the first solid tumour with an approved engineered T-cell receptor therapy.
Synovial sarcoma has nothing to do with the synovium; it is defined by the SS18-SSX fusion, which hijacks the BAF chromatin remodelling complex. It presents as a slow-growing deep mass near the knee, ankle or other joints in people aged 15 to 40, and is graded high by default. Treatment is wide resection with radiotherapy, and chemotherapy with ifosfamide and doxorubicin is used more readily than in other sarcomas because responses are frequent, including in the neoadjuvant setting; pazopanib and trabectedin have activity in advanced disease. Most tumours express the cancer-testis antigens MAGE-A4 and NY-ESO-1, and afamitresgene autoleucel, a MAGE-A4-directed T-cell receptor therapy, was approved in the United States in 2024 for advanced disease in HLA-A*02 patients, with letetresgene autoleucel against NY-ESO-1 following in trials.
| Setting | Approach | Guideline |
|---|---|---|
| Localised | Wide resection with pre- or postoperative radiotherapy; neoadjuvant or adjuvant ifosfamide-doxorubicin for large high-risk tumours. | not mapped |
| Advanced, first line | Ifosfamide-based chemotherapy, doxorubicin; pazopanib or trabectedin later. | not mapped |
| Advanced, HLA-A*02 and MAGE-A4-positive | Afamitresgene autoleucel after chemotherapy; NY-ESO-1 TCR therapy in trials. | not mapped |