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Sarcoma care in the era of precision medicine

Journal of internal medicine, 2023-12, Vol.294 (6), p.690-707 [Peer Reviewed Journal]

2023. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 0954-6820 ;ISSN: 1365-2796 ;EISSN: 1365-2796 ;DOI: 10.1111/joim.13717

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  • Title:
    Sarcoma care in the era of precision medicine
  • Author: Wallander, Karin ; Öfverholm, Ingegerd ; Boye, Kjetil ; Tsagkozis, Panagiotis ; Papakonstantinou, Andri ; Lin, Yingbo ; Haglund de Flon, Felix
  • Subjects: Availability ; Context ; Diagnosis ; Diagnostic systems ; Differential diagnosis ; Karyotypes ; MDM2 protein ; Medicin och hälsovetenskap ; Osteosarcoma ; Precision medicine ; Sarcoma ; Stat6 protein ; Synovial sarcoma ; Therapeutic targets ; Tumors
  • Is Part Of: Journal of internal medicine, 2023-12, Vol.294 (6), p.690-707
  • Description: Abstract Sarcoma subtype classification is currently mainly based upon histopathological morphology. Molecular analyses have emerged as an efficient addition to the diagnostic workup and sarcoma care. Knowledge about the sarcoma genome increases, and genetic events that can either support a histopathological diagnosis or suggest a differential diagnosis are identified, as well as novel therapeutic targets. In this review, we present diagnostic, therapeutic, and prognostic molecular markers that are, or might soon be, used clinically. For sarcoma diagnostics, there are specific fusions highly supportive or pathognomonic for a diagnostic entity—for instance, SYT :: SSX in synovial sarcoma. Complex karyotypes also give diagnostic information—for example, supporting dedifferentiation rather than low‐grade central osteosarcoma or well‐differentiated liposarcoma when detected in combination with MDM2 / CDK4 amplification. Molecular treatment predictive sarcoma markers are available for gastrointestinal stromal tumor (GIST) and locally aggressive benign mesenchymal tumors. The molecular prognostic markers for sarcomas in clinical practice are few. For solitary fibrous tumor, the type of NAB2 :: STAT6 fusion is associated with the outcome, and the KIT / PDGFRA pathogenic variant in GISTs can give prognostic information. With the exploding availability of sequencing technologies, it becomes increasingly important to understand the strengths and limitations of those methods and their context in sarcoma diagnostics. It is reasonable to believe that most sarcoma treatment centers will increase the use of massive‐parallel sequencing soon. We conclude that the context in which the genetic findings are interpreted is of importance, and the interpretation of genomic findings requires considering tumor histomorphology.
  • Publisher: Oxford: Blackwell Publishing Ltd
  • Language: English
  • Identifier: ISSN: 0954-6820
    ISSN: 1365-2796
    EISSN: 1365-2796
    DOI: 10.1111/joim.13717
  • Source: SWEPUB Freely available online
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