Ercolano on Molecular Drivers in Bone and Soft Tissue Sarcomas

Lisa B. Ercolano, MD, orthopedic oncologist and chief of musculoskeletal oncology at Allegheny Health Network, discusses the treatment of sarcomas in an era of molecular medicine.

Over 100 histological subtypes of sarcomas have been characterized to date, and with molecular profiling, many more are being discovered. As research in this space continues, clinicians hope to be able to use targeted treatments for specific mutations and further understand the molecular differences between tumor types.

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0:10 | We definitely have learned a lot in terms of being able to sequence these tumors and get down to the molecular level. I'd say that that's been most helpful in diagnosis thus far. There's a number of types of bone sarcomas, there's actually sort of hundreds of types of soft tissue sarcomas, and that number keeps getting longer and longer as we continue to sort of subdivide some of these out. That's where a lot of the molecular work has helped us.

0:44 | Whereas once there used to be an entity called malignant fibrous histiocytoma, that name doesn't even exist anymore for soft tissue sarcomas because now we know that that thing is actually many different things that we've been able to parse out. We've been able to do that with an understanding of the molecular differences between these different tumor types. Obviously, the goal is that that can turn into targeted treatments for each of these. That's definitely in the works, that's occurred, we have drugs that target these specific mutations that come about.

1:28 | Unfortunately, unlike some other types of cancers, we've not really hit the jackpot yet, in terms of finding drugs that drastically improve outcomes. There are some that we think help with prolonging what we call disease-free survival and things like that, but we haven't had any total breakthroughs yet. That speaks to the fact that we need more research and more money to do research, more clinical trials, more resources, in sarcoma, which is hard because it's a rare disease. It kind of gets lumped into the orphan diseases, and doesn't get as much notice or funding as other types of cancers.