Treatment of advanced soft tissue sarcoma: conventional agents and promising new drugs.

Effective treatment of advanced soft tissue sarcomas remains challenging, despite more than 30 years of clinical trials with conventional chemotherapy. Although some agents display modest efficacy against soft tissue sarcomas, modifications in the doses and combinations of therapies have not consistently led to significant improvements in response rates or concomitant increase in overall survival. Novel therapies designed to inhibit defined molecular alterations, as exemplified by the use of imatinib in gastrointestinal stromal tumors, have revolutionized the approach to the treatment of sarcomas. As more underlying genetic mechanisms are uncovered, new agents designed to target these lesions will lead to more specific, less toxic, and more effective therapies.