Targeted therapies for soft tissue sarcoma

Targeted therapy uses drugs to find and attack cancer cells. There are many different types of targeted therapy, including tyrosine kinase inhibitors (TKIs). Each type targets something in or around the cancer cell that is helping it grow and survive. They may be used to help to treat gastrointestinal stromal tumours gastrointestinal stromal tumour (GIST) or to control soft tissue sarcoma that has spread.

Targeted therapy drugs may be given as part of a research trial to treat soft tissue sarcoma.

Sunitinib is another TKI. It may be used to treat GISTs that do not respond to imatinib, or if you get a lot of side effects with imatinib.

Sunitinib blocks signals in the cancer cells. This stops a series of chemical reactions that make the cell grow and divide. It also helps stop the tumour developing new blood vessels. Without blood vessels, the tumour cannot get the nutrients it needs to survive.

You take sunitinib as a tablet. Some possible side effects include:

• tiredness (fatigue)
• high blood pressure
• diarrhoea
• sore hands and feet
• a skin rash
• changes to your hair colour
• thyroid changes.

Pazopanib is another TKI. It may be used to treat some types of advanced soft tissue sarcoma. It is taken once a day as tablets.

Possible side effects include:

• high blood pressure
• diarrhoea
• feeling or being sick
• tiredness (fatigue)
• a skin rash
• hair colour changes.

Pazopanib has not been approved by the National Institute for Health and Care Excellence (NICE) or the Scottish Medicines Consortium (SMC) for use on the NHS. Because of this, it may not be widely available.

Crizotinib may be used to treat a rare type of sarcoma called a myofibroblastic tumour. It is not available on the NHS but may be used in certain circumstances. You take it as capsules at home.

Larotrectinib can be used to treat cancers that have a change in a gene called NTRK. But this is not common in sarcoma, so it is rarely used. You have tests on the cancer cells to check for the gene change. You take it as capsules or sometimes as a liquid.

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