Synovial sarcoma
Prepared with OnCo (onco.cc/prep/synovial-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
15 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 SS18-SSX fusion, MAGE-A4 and NY-ESO-1 expression with HLA-A*02 typing, Size over 5 cm and poorly differentiated component), 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.Am I a candidate for Ifosfamide, Doxorubicin, and what side effects should I expect?
- 7.For my situation (advanced, first line), which of the standard options do you recommend and why?
- 8.Am I a candidate for Ifosfamide, Doxorubicin, Pazopanib or related drugs, and what side effects should I expect?
- 9.For my situation (advanced, hla-a*02 and mage-a4-positive), which of the standard options do you recommend and why?
- 10.Am I a candidate for Afamitresgene autoleucel, and what side effects should I expect?
- 11.Are there clinical trials I could join, for example of Letetresgene autoleucel?
- 12.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 13.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 14.I read that “TCR therapy needs a matching HLA type and antigen, excluding most patients”. How does that affect my plan?
- 15.I read that “Late lung metastases years after treatment”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: SS18-SSX fusion (FISH or RNA sequencing; SS18-SSX antibody), MAGE-A4 and NY-ESO-1 expression with HLA-A*02 typing (TCR therapy eligibility), Size over 5 cm and poorly differentiated component (prognosis).
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 resection with pre- or postoperative radiotherapy; neoadjuvant or adjuvant ifosfamide-doxorubicin for large high-risk tumours. (IMRT / IGRT (modern external beam), Ifosfamide, Doxorubicin)
- Advanced, first line: Ifosfamide-based chemotherapy, doxorubicin; pazopanib or trabectedin later. (Ifosfamide, Doxorubicin, Pazopanib, Trabectedin)
- Advanced, HLA-A*02 and MAGE-A4-positive: Afamitresgene autoleucel after chemotherapy; NY-ESO-1 TCR therapy in trials. (Afamitresgene autoleucel)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.