{"entity":{"id":"paper-isg-sts-1001-gronchi-lancet-oncol-2017","kind":"paper","name":"ISG-STS 1001: histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in high-risk soft tissue sarcoma","aka":[],"tldr":"Trying to match neoadjuvant chemotherapy to sarcoma subtype backfired: standard epirubicin-ifosfamide gave better disease-free and overall survival than the tailored regimens, and in doing so provided evidence that neoadjuvant anthracycline-ifosfamide itself helps high-risk patients.","summary":"Phase 3 trial of 287 patients with high-risk localised soft tissue sarcoma of the limbs or trunk wall in five histological subtypes randomised to three cycles of neoadjuvant epirubicin-ifosfamide or a histotype-tailored regimen (gemcitabine-docetaxel, trabectedin, high-dose ifosfamide, etoposide-ifosfamide or gemcitabine-dacarbazine).\n\nThe trial stopped early for futility: 46-month disease-free survival was 62 percent with standard chemotherapy against 38 percent with tailored regimens, and overall survival 89 versus 64 percent, with the difference driven by undifferentiated pleomorphic sarcoma and other subtypes.","asOf":"2026-09-17","links":[{"label":"Lancet Oncol 2017","url":"https://doi.org/10.1016/S1470-2045(17)30334-0"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28499583/"}],"tags":[],"related":[],"cancers":["extremity-soft-tissue-sarcoma","undifferentiated-pleomorphic-sarcoma","synovial-sarcoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["isg-sts-1001"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2017,"doi":"10.1016/S1470-2045(17)30334-0","pmid":"28499583","authors":"Gronchi A, Ferrari S, Quagliuolo V, et al.","paperType":"rct","findings":["46-month disease-free survival 62 percent (standard) vs 38 percent (tailored).","Overall survival 89 percent vs 64 percent."],"whatItMeans":"Three cycles of neoadjuvant anthracycline-ifosfamide is a reasonable standard for fit patients with high-risk limb or trunk sarcoma, particularly undifferentiated pleomorphic sarcoma.","caveats":["Absence of a surgery-alone arm means the benefit of chemotherapy is inferred rather than proven.","Tailored regimens performed worse partly because some had little single-agent activity."],"changedPractice":true,"participants":287},"route":"/key-papers/paper-isg-sts-1001-gronchi-lancet-oncol-2017/","neighbours":{"cancer":[{"id":"extremity-soft-tissue-sarcoma","kind":"cancer","name":"Soft tissue sarcoma of the extremity (localised and advanced)","route":"/cancers/extremity-soft-tissue-sarcoma/"},{"id":"synovial-sarcoma","kind":"cancer","name":"Synovial sarcoma","route":"/cancers/synovial-sarcoma/"},{"id":"undifferentiated-pleomorphic-sarcoma","kind":"cancer","name":"Undifferentiated pleomorphic sarcoma (UPS)","route":"/cancers/undifferentiated-pleomorphic-sarcoma/"}],"trial":[{"id":"isg-sts-1001","kind":"trial","name":"ISG-STS 1001","route":"/trials/isg-sts-1001/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}