Liposarcoma medical therapy

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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

Treatment of liposarcoma is based on an integrated approach by a multidisciplinary team based on the medical history and physical examination, imaging, biopsy and genetic studies of the tumor. Chemotherapy, chemoradiation, immunotherapy and targeted therapy are the different types of medical therapy for liposarcoma.

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

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.

• Chemoradiation

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

• 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.

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
Nilotnib	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
Temozolamide	Chemotherapy
Toremifene citrate	Targeted therapy
Vinblastine citrate	Chemotherapy
Vinblastine tartarate	Chemotherapy

Regimen

Drugs	Dose
Doxurubicin	Doxurubicin 75 mg/m2; 28 day cycle
Pegylated liposomal doxurubicin	40-50 mg/m2 ; 28 day cycle
AI regimen	Doxurubicin 25 mg/m2,Ifosfamide 3g/m2 21 day cycle
MAID regimen	Doxurubicin 20 mg/m2, ifosfamide 2.5g/m2, Dacarbazine 300mg/m2 21 day cycle
AD regimen	Doxurubicin 20 mg/m2, Dacarbazine 300mg/m2; 21 day cycle
Metronomic cyclophosphamide	Oral daily cyclophosphamide 50mg/day for 21 dyas on 28 day cycle
Docetaxel-Gemcitabine	Gemcitabine 900 mg/m2 , Docetaxel 100 mg/m2 for 21 day cycle
Trabectidin	Trabectidin 1.5mg/m2 21 day cycle