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Standard anthracycline-ifosfamide before surgery beat subtype-tailored chemotherapy, and indirectly showed neoadjuvant chemotherapy helps high-risk sarcoma.
ISG-STS 1001, trial NCT01710176 sponsored by the Italian Sarcoma Group and published in Lancet Oncology in 2017, found that standard neoadjuvant epirubicin and ifosfamide beat subtype-tailored chemotherapy in high-risk localised soft-tissue sarcoma of the extremities and trunk, and indirectly showed that neoadjuvant chemotherapy helps in this setting. It randomised 287 patients and was stopped early when disease-free and overall survival at 46 months favoured the standard arm, and long-term follow-up confirmed the benefit against historical controls, establishing three cycles of neoadjuvant anthracycline and ifosfamide for grade 3, deep tumours over five centimetres. Whether tailored regimens fail because the histotypes were wrong or the drugs were weaker is the open question.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), Ifosfamide, Sarcomas (soft tissue, bone, GIST).
Shares Histotype-tailored therapy, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), Sarcomas (soft tissue, bone, GIST).
Shares FNCLCC grade (soft-tissue sarcoma), Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), Ifosfamide.
Shares Alessandro Gronchi, Histotype-tailored therapy, Sarcomas (soft tissue, bone, GIST).
Shares Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), Ifosfamide.
Shares Italian Sarcoma Group, Alessandro Gronchi, Sarcomas (soft tissue, bone, GIST).
Shares Ifosfamide, Sarcomas (soft tissue, bone, GIST), Cytotoxic chemotherapy.
Shares FNCLCC grade (soft-tissue sarcoma), Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), Ifosfamide.