Ariad Pharmaceuticals Inc fka ARIA

[BTH]

Paolo Casali is a Board Member of ESMO, Medical Oncologist at the National Cancer Institute in Milan, and an international expert on sarcomas. He remembers the time when soft tissue sarcomas were treated in exactly the same way, lumped together as one rarish disease. After (failed) surgery, either doxorubicin, or ifosfamide and mesna, or all three were given, irrespective of histotype. One size fitted all. This Special Symposium on sarcomas blows that strategy out the water. Not only are the new targeted drugs dependant on histological subtype (imatinib and GIST led the way), but it seems that on closer scrutiny some of the old fashioned cytotoxic drugs are better in some sarcomas than others. When asked why gemcitabine is active in leiomyosarcomas and angiosarcomas, Paolo admits that the molecular basis "remains a mystery"! Taxanes and dacarbazine are also more useful in angiosarcomas than other subtypes. A recent addition to the cytotoxic armamentarium is trabectidin which acts like a cytotoxic in shrinking leiomyosarcomas and some liposarcomas, but resembles a targeted agent in displaying excellent activity in those myxoid liposarcomas which have a specific translocation. This symposium will go into detail on why sorafenib and sunitinib have specific activity for instance in solitary fibroid sarcomas, anti- Insulin Growth Factor receptor drugs target Ewing's sarcoma and anti-mTor drugs may be useful in lymphangiosarcoma. Never has the histopathologist been more important in the cancer management of patients than with these rare tumors, and never has it been so critical that they are always referred to a specialist cancer center. The take-home message is that "One drug does not fit all!".