Targeted Therapies and Immunotherapy Play Greater Role in Sarcomas

Neeta Somaiah, MD, an associate professor and deputy department chair in the department of sarcoma medical oncology, division of cancer medicine at The University of Texas MD Anderson Cancer Center, discusses new and upcoming targeted therapies for sarcomas at the Inaugural Miami Cancer Institute Precision Medicine Oncology Symposium.

Due to the variety of sarcomas, different targets are under investigation. According to Somaiah, liposarcomas and desmoid sarcomas are subtypes where targeted therapies have shown efficacy, including CDK4 inhibitors and MDM2 inhibitors. Gamma secretase inhibitors have been employed in Kaposi sarcoma. Additionally, FGFR and IDH mutations have shown potential as targets in some soft tissue sarcomas and bone sarcomas.

Somaiah says that immunotherapy is an important area of investigation for her, though there is a challenge in finding the right subtype that will respond to immunotherapy. Combination immunotherapies are under investigation in patients with soft tissue and bone sarcoma, but the same combinations used in other cancers may not be effective in sarcomas. Currently the only sarcoma with an approved immunotherapy is alveolar soft part sarcoma, where pembrolizumab (Keytruda) alone or in combination with axitinib (Inlyta) are preferred regimens.

TRANSCRIPTION:

0:08 | We have targets within the liposarcoma space, we have CDK4 inhibitors, MDM2 inhibitors that are of interest. In the desmoid space, there are newer gamma secretase inhibitors that are being looked at, similarly there are specific mutations in FGFR or IDH, etc, that are being targeted across certain soft tissue sarcomas and bone sarcomas.

I personally am very interested in advancing immunotherapy in the sarcoma space. The challenge there is finding the right subtypes that will respond and also finding the right type of immunotherapy combinations that will be helpful for these [patients with sarcoma] that are different than some of the carcinomas that we see. I think there are some combination trials that we'll be seeing in the future that we hope can bring the immunotherapy into the soft tissue and bone sarcoma spaces as well. Right now, [immunotherapy] is only approved for a small subtype called alveolar soft part sarcomas.