Leiomyosarcoma
Prepared with OnCo (onco.cc/prep/leiomyosarcoma/). 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 TP53, RB1 and ATRX alterations, Gradeand size, Smooth muscle markers, Oestrogen and progesterone receptor in uterine tumours), 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 (metastatic, first line), which of the standard options do you recommend and why?
- 7.Am I a candidate for Doxorubicin, Trabectedin, Gemcitabine or related drugs, and what side effects should I expect?
- 8.For my situation (later lines), which of the standard options do you recommend and why?
- 9.Am I a candidate for Trabectedin, Pazopanib, Letrozole (and other aromatase inhibitors), and what side effects should I expect?
- 10.Are there clinical trials I could join, for example of Trabectedin?
- 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 “No targeted or immune therapy works in most patients”. How does that affect my plan?
- 14.I read that “Uterine tumours are still discovered by accident after fibroid surgery”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: TP53, RB1 and ATRX alterations, Grade (FNCLCC) and size, Smooth muscle markers (desmin, h-caldesmon, SMA), Oestrogen and progesterone receptor in uterine tumours (hormone therapy in low-grade disease).
Scans and tests linked to this cancer: Methylation classifier for sarcomas.
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 surgical resection; radiotherapy for limb and trunk tumours; no morcellation of uterine masses that could be sarcoma; adjuvant chemotherapy not standard. (IMRT / IGRT (modern external beam))
- Metastatic, first line: Doxorubicin plus trabectedin (LMS-04) or doxorubicin alone; gemcitabine-docetaxel as an alternative, especially in uterine disease. (Doxorubicin, Trabectedin, Gemcitabine, Docetaxel)
- Later lines: Trabectedin, pazopanib, dacarbazine-based regimens, aromatase inhibitors in hormone receptor-positive low-grade uterine disease; metastasectomy for limited lung spread. (Trabectedin, Pazopanib, Letrozole (and other aromatase inhibitors))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.