Understanding the Biology of Uterine Sarcoma

Matthew Ingham, MD, an assistant professor of Medicine in the Division of Hematology and Oncology at New York Presbyterian Hospital/Columbia University Medical Center, discusses some of the most recent clinical updates in the sarcoma space.

According to Ingham, uterine sarcoma is a rare disease that has many different subtypes. Because each of these subtypes differ from one another both biologically and clinically, it is important for experts to understand all of them. Each of these subtypes should be treated individually as they are all different and can be genomically complex.

Further, experts believe they have found a BRCA like phenotype in uterine leiomyosarcoma. This has led to the development of multiple clinical trials that are evaluating a number of targeted drugs for this patient population.

Transcription:

0: 08 | To focus on uterine sarcomas, it really is a challenging disease to treat when it's metastatic. We do have some chemotherapy options, so we use drugs like doxorubicin or gemcitabine plus docetaxel. Those have been the standard chemotherapy treatment for many years. They do certainly have some efficacy, but they have a fair amount of toxicity. Unfortunately, progression-free survival is relatively short. I think what we're trying to do with uterine sarcoma is to really understand the biology so that we can develop treatment approaches that are more targeted.

0:37 | Probably the most exciting development in the field, which I think is really taking a collaborative effort from a lot of research groups working together, is that it does seem that as a subset of uterine leiomyosarcoma, they have a defect in their ability to repair their DNA. It's sort of what we call a practice like phenotype. So people have probably heard about BRCA in ovarian cancer, breast cancer, and really what BRCA mutations do is that they impart a vulnerability and sort of a deficiency in the cancers ability to repair certain types of DNA damage, and it makes them sensitive to certain targeted treatment approaches with DNA damaging agents. We think that we've found a BRCA like phenotype in uterine leiomyosarcoma. That has prompted a number of clinical trials that are looking at targeted drugs to take advantage of that to hopefully offer patients a more targeted, less toxic, and more effective treatment option.