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TREATMENT POSSIBILITIES

Below is a listing of some approved Leiomyosarcoma treatments as well as a few currently in trial or being researched for LMS patients. This list is for informational purposes only and LMSdr is not recommending any of these treatments. Any decisions in health care should be made by the patient and their physician.

Surgery is the first choice for LMS treatment, and includes:
  • Removal of the primary tumor with wide margins (at least 1 cm).
  • Re-excision if primary tumor was not removed with wide margins.
  • Removal of metastases (other sites of tumor not the primary), if possible.
  • Laser surgery of very abundant lung tumors is available as a surgical procedure in Germany.

Chemotherapy uses traditional cytotoxic drugs which destroy all fast growing cells, healthy as well as cancerous. First line choices for LMS are:
  • Gem/Tax (Gemzar + Taxotere)
  • AIM (Adriamycin + Ifex + Mesna)
Individual chemo agents are:

  • Adriamycin (doxorubicin)
  • Ifex (ifosfamide)
  • Gemzar (gemcitabine)
  • Taxotere (docetaxel)
  • Temodar (temozolomide) oral, same drug as, DTIC (dacarbazine) intravenously
  • Currently in trial showing good response in Sarcoma is ET-743 (Trabectedin / Yondelis).


Targeted drugs are not traditional cytotoxic drugs, but are targeted to interfere or inhibit pathways to disrupt growth of tumor cells. Typically these drugs have milder side effects. Currently, researchers are focusing on targeted drugs for many types of cancer including Sarcoma. There are a multitude of these agents that are approved or available in clinical trials, which include:
  • Angiogenesis inhibitors
  • Tyrosine kinase inhibitors
  • Tumor vascular disruptors
  • mTOR inhibitors (see the AP23573 trial)
  • Minor groove binders of DNA
  • Spindle disruptors
  • Histone deacetylase inhibitors

Radiation Therapy includes many types of radiation and delivery:
  • Straight fields
  • Brachytherapy (internal)
  • Computerized conformational beams (IMRT, cyberknife, radiosurgery & gamma knife)
  • Proton, electron or neutron beams
  • Radioisotope treatments of several sorts

Interventional Radiology Treatments are varied. These techniques are not usually in initial treatment, but are useful options if there are recurrences.
  • RFA (radio frequency ablation)
  • Cryoablation
  • Chemoembolization
  • Embolization
  • Other techniques

Immunotherapy is still in early stages of investigation to find ways to stimulate the immune system to recognize and destroy cancer cells. These experimental techniques include:
  • Antigen vaccines
  • Anti-idiotype vaccines
  • Dendritic cell vaccines
  • DNA vaccines
  • Tumor cell vaccines
  • Viral therapy
  • Gene therapy

Hormonal Therapy for uterine LMS may be useful if the tumor cells have estrogen or progesterone receptors that stimulate tumor cell growth. Aromatase inhibitors (estrogen blockers) for post menopausal women are:
  • Arimidex (anastrozole)
  • Aromasin (exemestane)
  • Femara (letrozole)
    Warning: Tamoxifen has been contra-indicated for uterine LMS in recent studies.

 

For more information on Leiomyosarcoma & treatment options, you can visit the website by D. Kossove, M.D. who was an LMS patient and a volunteer on the LMSdr Scientific Advisory Committee.
www.leiomyosarcoma.info

 


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Last Edited - 1 August 2012 08:59 am
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