Liposarcoma medical therapy: Difference between revisions

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==Overview==
==Overview==
Chemotherapy, chemoradiation, immunotherapy and targeted therapy are the different types of medical therapy for liposarcoma.
[[Medicine|Medical]] [[therapy]] for liposarcoma includes [[Chemotherapy]], chemoradiation, [[immunotherapy]], and targeted [[therapy]].


===Medical Therapy===
==Medical Therapy==
'''Chemotherapy''' may be used with radiation therapy either before or after surgery to try to shrink the tumor or kill any remaining cancer cells. In general, chemotherapy effects for soft tissue sarcoma have had little impact as opposed to other cancers.  If the cancer has spread to other areas of the body, chemotherapy may be used to shrink tumors and reduce the pain and discomfort they cause, but is unlikely to eradicate the disease. The use of chemotherapy to prevent the spread of soft tissue sarcomas has not been proven to be effective. Patients with soft tissue sarcomas usually receive chemotherapy intravenously (injected into a blood vessel).


*Chemotherapy
=== Chemotherapy ===
It is used to kill cancer cells by various mechanisms like damaging DNA or damaging the making of DNA. It can be used as primary, adjuant or neoadjuant therapy. It is also used to treat metastasis also. Usually 2 or more chemotherapy drugs are given in combination to treat the disease. They are given in cycles of treatment days followed by days of rest. The length of the cycles varies depending on the drug used. The cycles of chemotherapy helps the body to recover faster.
* [[Chemotherapy]] may be used with [[radiation therapy]] either before or after [[surgery]] to shrink the [[tumor]] or kill any remaining [[cancer cells]].  
*Chemoradiation
* If the [[cancer]] has spread to other areas of the [[Human body|body]], [[chemotherapy]] may be used to shrink [[tumors]] and reduce the associated [[pain]] and [[discomfort]].
Sometimes the targeted therapy is given along with radiation . They may be given together or at different intervals.
* [[Patients]] with [[soft tissue]] [[Sarcoma|sarcomas]] usually receive [[chemotherapy]] [[Intravenous therapy|intravenously]].
*Targeted therapy
It stops the growth of the molecules involved in growth of cancer cells. It blocks the growth signals. Most targettd therapy comes in pill form and some needs to be injected.
*Immunotherapy
Immune system is the body's natural defense against infection and disease. Immunotherapy increases your activity of the immune system and improves body's ability to find and destroy cancer cells.
Few of the drugs used for immune therapy are listed below.<ref name=NCCN>{{cite web | title = NCCN | url = http://www.nccn.org/professionals/physician_gls/f_guidelines.asp }}</ref>


{|style=" border: 0px; font-size: 90%; margin: 3px;"
=== Chemoradiation ===
! style="padding: 0 5px; width: 150px; background: #4479BA; font-weight: bold;"| {{fontcolor|#FFFFFF|Drug}}
* Sometimes the targeted [[therapy]] is given along with [[Radiation therapy|radiation]].
! style="padding: 0 5px; width: 50px; background: #4479BA; font-weight: bold;" | {{fontcolor|#FFFFFF|Type of drug}}
* They may be given together or at different intervals.
 
=== Targeted Therapy ===
* It stops the growth of the [[Molecule|molecules]] involved in growth of [[cancer cells]].
* It blocks the growth signals.
* Most targeted [[therapy]] comes in [[Pill (pharmacology)|pill]] form and some needs to be [[Injection (medicine)|injected]].
 
=== Immunotherapy ===
* [[Immunotherapy]] increases the activity of the [[immune system]] and improves [[Human body|body's]] ability to find and destroy [[cancer cells]].
* Few of the [[Drug|drugs]] used for [[immune]] [[therapy]] are listed below.<ref name="NCCN">{{cite web | title = NCCN Guidelines for Patients - Soft Tissue Sarcoma | url =http://www.nccn.org/patients/guidelines/sarcoma/index.html#2 }}</ref>
{| style=" border: 0px; font-size: 90%; margin: 3px;"
! style="padding: 0 5px; width: 150px; background: #4479BA; font-weight: bold;" | {{fontcolor|#FFFFFF|Drug}}
! style="padding: 0 5px; width: 150px; background: #4479BA; font-weight: bold;" | {{fontcolor|#FFFFFF|Type of drug}}
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Bevacizumab
| style="padding: 0 5px; background: #DCDCDC;" | [[Bevacizumab]]
| style="padding: 0 5px; background: #F5F5F5;" | Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" | Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Celecoxib
| style="padding: 0 5px; background: #DCDCDC;" | [[Celecoxib]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Crizotinib
| style="padding: 0 5px; background: #DCDCDC;" | [[Crizotinib]]
| style="padding: 0 5px; background: #F5F5F5;" | Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" | Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Dacarbazine
| style="padding: 0 5px; background: #DCDCDC;" | [[Dacarbazine]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Dasatinib
| style="padding: 0 5px; background: #DCDCDC;" | [[Dasatinib]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Docetaxel
| style="padding: 0 5px; background: #DCDCDC;" | [[Docetaxel]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Doxorubicin
| style="padding: 0 5px; background: #DCDCDC;" | [[Doxorubicin]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Epirubicin hydrochloride
| style="padding: 0 5px; background: #DCDCDC;" | [[Epirubicin hydrochloride]]
| style="padding: 0 5px; background: #F5F5F5;" |Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" |[[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Everolimus
| style="padding: 0 5px; background: #DCDCDC;" | [[Everolimus]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Gemcitabine hydrochloride
| style="padding: 0 5px; background: #DCDCDC;" | [[Gemcitabine]] [[hydrochloride]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" |Ifosfamide
| style="padding: 0 5px; background: #DCDCDC;" |[[Ifosfamide]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" |Imatinib mesylate
| style="padding: 0 5px; background: #DCDCDC;" |[[Imatinib mesylate]]
| style="padding: 0 5px; background: #F5F5F5;" | Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" | Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Interferon alpha 2B
| style="padding: 0 5px; background: #DCDCDC;" | [[Interferon alpha|Interferon alpha 2B]]
| style="padding: 0 5px; background: #F5F5F5;" | Immunotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Immunotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Mesna
| style="padding: 0 5px; background: #DCDCDC;" | [[Mesna]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Methotrexate
| style="padding: 0 5px; background: #DCDCDC;" | [[Methotrexate]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Nilotnib
| style="padding: 0 5px; background: #DCDCDC;" | [[Nilotinib]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Paclitaxel
| style="padding: 0 5px; background: #DCDCDC;" | [[Paclitaxel]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Pazopanib
| style="padding: 0 5px; background: #DCDCDC;" | [[Pazopanib]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy  
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Regorafenib
| style="padding: 0 5px; background: #DCDCDC;" | [[Regorafenib]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Sorafenib tosylate
| style="padding: 0 5px; background: #DCDCDC;" | [[Sorafenib]] [[tosylate]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Sirolimus
| style="padding: 0 5px; background: #DCDCDC;" |[[Sirolimus]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Sulindac
| style="padding: 0 5px; background: #DCDCDC;" | [[Sulindac]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Sunitinib malate
| style="padding: 0 5px; background: #DCDCDC;" | [[Sunitinib malate]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Tamoxifen citrate
| style="padding: 0 5px; background: #DCDCDC;" | [[Tamoxifen citrate]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Temozolamide
| style="padding: 0 5px; background: #DCDCDC;" | [[Temozolomide]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Toremifene citrate
| style="padding: 0 5px; background: #DCDCDC;" | [[Toremifene Citrate|Toremifene citrate]]
| style="padding: 0 5px; background: #F5F5F5;" |Targeted therapy  
| style="padding: 0 5px; background: #F5F5F5;" |Targeted [[therapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Vinblastine citrate
| style="padding: 0 5px; background: #DCDCDC;" | [[Vinblastine]] citrate
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|-
|-
| style="padding: 0 5px; background: #DCDCDC;" | Vinblastine tartarate
| style="padding: 0 5px; background: #DCDCDC;" | [[Vinblastine]] [[tartrate]]
| style="padding: 0 5px; background: #F5F5F5;" | Chemotherapy
| style="padding: 0 5px; background: #F5F5F5;" | [[Chemotherapy]]
|}
|}


===Regimen===
===Regimen===


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|valign=top|
| valign="top" |
|+
|+
! style="background: #4479BA; width: 250px;" | {{fontcolor|#FFF|Drugs}}
! style="background: #4479BA; width: 250px;" | {{fontcolor|#FFF|Drugs}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Dose}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Dose}}
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Doxurubicin
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Doxorubicin]]
| style="padding: 5px 5px; background: #F5F5F5;" |Doxurubicin 75 mg/m2; 28 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |[[Doxorubicin hydrochloride|Doxorubicin]] 75 mg/m2; 28 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Pegylated liposomal doxurubicin
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[PEGylation|Pegylated]] [[Liposome|liposomal]] [[doxorubicin]]
| style="padding: 5px 5px; background: #F5F5F5;" |40-50 mg/m2 ; 28 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |40 - 50 mg/m2 ; 28 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |AI regimen
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |AI regimen
| style="padding: 5px 5px; background: #F5F5F5;" |Doxurubicin 25 mg/m2, Ifosfamide 3g/m2 21 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |[[Doxorubicin hydrochloride|Doxorubicin]] 25 mg/m2, [[Ifosfamide]] 3 g/m2 21 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |MAID regimen
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |MAID regimen
| style="padding: 5px 5px; background: #F5F5F5;" |Doxurubicin 20 mg/m2, ifosfamide 2.5g/m2, Dacarbazine 300mg/m2 21 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |[[Doxorubicin]] 20 mg/m2, [[Ifosfamide]] 2.5 g/m2, [[Dacarbazine]] 300mg/m2 21 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |AD regimen
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |AD regimen
| style="padding: 5px 5px; background: #F5F5F5;" |Doxurubicin 20 mg/m2, Dacarbazine 300mg/m2; 21 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |[[Doxorubicin]] 20 mg/m2, [[Dacarbazine]] 300 mg/m2; 21 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Metronomic cyclophosphamide
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Metronomic [[cyclophosphamide]]
| style="padding: 5px 5px; background: #F5F5F5;" |Oral daily cyclophosphamide 50mg/day for 21 dyas on 28 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |Oral daily [[cyclophosphamide]] 50mg/day for 21 days on 28 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Docetaxel-Gemcitabine
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Docetaxel]]-[[Gemcitabine]]
| style="padding: 5px 5px; background: #F5F5F5;" |Gemcitabine 900 mg/m2 , Docetaxel 100 mg/m2 for 21 day cycle
| style="padding: 5px 5px; background: #F5F5F5;" |[[Gemcitabine]] 900 mg/m2 , [[Docetaxel]] 100 mg/m2 for 21 day cycle
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Trabectidin
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Trabectedin]]
| style="padding: 5px 5px; background: #F5F5F5;" |Trabectidin 1.5mg/m2 21 day cycle<ref name=AO>{{cite web | title = Liposarcoma | url = http://annonc.oxfordjournals.org/content/23/6/1601/T2.expansion.html }}</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |[[Trabectedin]] 1.5 mg/m2 21 day cycle<ref name="AO">{{cite web | title = Liposarcoma | url = http://annonc.oxfordjournals.org/content/23/6/1601/T2.expansion.html }}</ref>
|}
|}


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[[Category:Disease]]
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Oncology]]
[[Category:Surgery]]
[[Category:Surgery]]
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]

Latest revision as of 19:46, 29 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Medical therapy for liposarcoma includes Chemotherapy, chemoradiation, immunotherapy, and targeted therapy.

Medical Therapy

Chemotherapy

Chemoradiation

  • Sometimes the targeted therapy is given along with radiation.
  • They may be given together or at different intervals.

Targeted Therapy

Immunotherapy

Drug Type of drug
Bevacizumab Targeted therapy
Celecoxib Targeted therapy
Crizotinib Targeted therapy
Dacarbazine Chemotherapy
Dasatinib Targeted therapy
Docetaxel Chemotherapy
Doxorubicin Chemotherapy
Epirubicin hydrochloride Chemotherapy
Everolimus Chemotherapy
Gemcitabine hydrochloride Chemotherapy
Ifosfamide Chemotherapy
Imatinib mesylate Targeted therapy
Interferon alpha 2B Immunotherapy
Mesna Chemotherapy
Methotrexate Chemotherapy
Nilotinib Chemotherapy
Paclitaxel Chemotherapy
Pazopanib Targeted therapy
Regorafenib Targeted therapy
Sorafenib tosylate Targeted therapy
Sirolimus Chemotherapy
Sulindac Chemotherapy
Sunitinib malate Targeted therapy
Tamoxifen citrate Targeted therapy
Temozolomide Chemotherapy
Toremifene citrate Targeted therapy
Vinblastine citrate Chemotherapy
Vinblastine tartrate Chemotherapy

Regimen
Drugs Dose
Doxorubicin Doxorubicin 75 mg/m2; 28 day cycle
Pegylated liposomal doxorubicin 40 - 50 mg/m2 ; 28 day cycle
AI regimen Doxorubicin 25 mg/m2, Ifosfamide 3 g/m2 21 day cycle
MAID regimen Doxorubicin 20 mg/m2, Ifosfamide 2.5 g/m2, Dacarbazine 300mg/m2 21 day cycle
AD regimen Doxorubicin 20 mg/m2, Dacarbazine 300 mg/m2; 21 day cycle
Metronomic cyclophosphamide Oral daily cyclophosphamide 50mg/day for 21 days on 28 day cycle
Docetaxel-Gemcitabine Gemcitabine 900 mg/m2 , Docetaxel 100 mg/m2 for 21 day cycle
Trabectedin Trabectedin 1.5 mg/m2 21 day cycle[2]

References

  1. ↑ "NCCN Guidelines for Patients - Soft Tissue Sarcoma".
  2. ↑ "Liposarcoma".

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