What to Consider When Determining the Appropriateness of Chemotherapy for Soft-Tissue Sarcoma
In round 3 of the debate mediated by Brian Van Tine, MD, PhD, experts Jonathan Trent, MD, PhD, and Robin Jones, BSc, MB BS, MRCP, MD (Res), debated which patient characteristics should be considered when determining the appropriateness of using adjuvant/neoadjuvant chemotherapy for the treatment of soft-tissue sarcoma.
Listen to a preview of Dr Jones' argument, in which he explains the risks of using adjuvant/neoadjuvant therapy in this setting, and why patients may opt to not follow through with this regimen.
Transcript
As Jon mentioned earlier on, some patients decide that they don’t want to have chemotherapy because the supporting evidence is not to the standard that they would like, plus there is the small but very important risk of long-term complications, such as secondary leukemias, cardiac and renal toxicity. I think as well, as Jon mentioned, ifosfamide is a toxic drug. It’s a very effective drug, a very important drug, but it clearly is a drug that we need to be thoughtful and careful administering to individual people. And clearly, we need to take into consideration performance status, comorbidities, age, concurrent medication, when weighing up the pros and cons of neoadjuvant or adjuvant chemotherapy. So, I think we need to be conscious of all of these things when discussing the role of neoadjuvant/adjuvant chemotherapy.
