Treatment of uterine leiomyosarcoma

This article is a review of uterine leiomyosarcomas treatment options. Based on the data from different trials we recommend the following treatment strategy. Surgery: total hysterectomy must be done in localized disease, further adjuvant chemotherapy is possible, but the decision should be taken individually. Adjuvant radiation therapy is not recommended due to low influence on overall survival. Advanced uterine leiomyosarcomas should be treated by combined chemotherapy. As a first line we recommend combined regimens including doxorubicin, dacarbazine, ifosfamide and gemcitabine, docetaxel. Trabectedin monotherapy as a 24-hour infusion showed good result in long-term SD and can be used as a second or further lines of treatment. Hormone therapy is possible as supportive treatment if status of steroid hormone receptors in the tumor is positive. The decision on second look surgery in advanced disease should be discussed individually. Also our data of trabectedin use in pts with uterine leiomyosarcomas is fully discussed. We got the same treatment and toxicity results as in STS-201. After the dose reduction till 1,3 mg/m² we got more favorable toxicity profile with the same efficacy but further investigation is needed.