Alveolar soft part sarcoma
Prepared with OnCo (onco.cc/prep/alveolar-soft-part-sarcoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
14 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example ASPSCR1-TFE3 fusion, PAS-positive, diastase-resistant crystals, Brain imaging surveillance for metastases), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (localised), which of the standard options do you recommend and why?
- 6.For my situation (advanced, first line), which of the standard options do you recommend and why?
- 7.Am I a candidate for Atezolizumab, Sunitinib, Pazopanib or related drugs, and what side effects should I expect?
- 8.How do the results of Phase III Trial of Anlotinib, Catequentinib in Advanced Alveolar Soft Part Sarcoma, Leiomyosarcoma, Synovial Sarcoma (APROMISS) apply to someone like me?
- 9.For my situation (oligometastatic), which of the standard options do you recommend and why?
- 10.Are there clinical trials I could join, for example of Atezolizumab, Anlotinib, Clinical Trials of Benmelstobart Injection Combined With Anlotinib Hydrochloride Capsules in the Treatment of Advanced or Unresectable Alveolar Soft Part Sarcoma, Phase III Trial of Anlotinib, Catequentinib in Advanced Alveolar Soft Part Sarcoma, Leiomyosarcoma, Synovial Sarcoma (APROMISS)?
- 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 13.I read that “Why a low-mutation fusion sarcoma responds to immunotherapy is not understood”. How does that affect my plan?
- 14.I read that “Brain metastases are common and hard to treat”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: ASPSCR1-TFE3 fusion (FISH or RNA sequencing; TFE3 immunohistochemistry), PAS-positive, diastase-resistant crystals, Brain imaging surveillance for metastases.
Scans and tests linked to this cancer: MRI, MRD / molecular residual disease testing.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised: Wide resection with radiotherapy for close or positive margins; surveillance of lungs and brain. (Limb-salvage surgery and endoprosthetic reconstruction, IMRT / IGRT (modern external beam), MRI)
- Advanced, first line: Atezolizumab (FDA approved 2023) or a VEGFR kinase inhibitor (sunitinib, pazopanib; anlotinib in China); conventional chemotherapy is not used. (Atezolizumab, Immune checkpoint inhibitors, Sunitinib, Pazopanib, Anlotinib, Phase III Trial of Anlotinib, Catequentinib in Advanced Alveolar Soft Part Sarcoma, Leiomyosarcoma, Synovial Sarcoma (APROMISS))
- Oligometastatic: Metastasectomy or stereotactic radiotherapy to lung and brain lesions in slowly progressing disease. (SBRT / SABR (stereotactic radiotherapy), Limb-salvage surgery and endoprosthetic reconstruction)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.