[Histology-Specific Chemotherapy in Soft-Tissue Sarcomas].

Soft-tissue sarcomas(STSs)are rare mesenchymal tumors, accounting for less than 1%of all adult malignancies. STSs also have diversity, with more than 50 different histological subtypes. While surgical complete resection is a definitive treatment for localized STS, chemotherapy is the treatment option for managing locally advanced and metastatic STS. Although doxorubicin ±ifosfamide is still the first-line therapy for most STS subtypes, some STSs(alveolar soft part sarcoma, clear cell sarcoma, epithelioid sarcoma and extraskeletal myxoid chondrosarcoma)have been reported to have little response to these cytotoxic chemotherapies. Additionally, the treatment options after the failure of first-line therapy were very limited. The recent emergence of new therapeutic options in Japan allows us to treat patients with second-line therapy, including pazopanib, trabectedin and eribulin. However the priority and potential role of these drugs as second-line therapy are still controversial, and the outcomes with these drugs are still unsatisfactory due to the low contribution of response and survival rates. As increasing numbers of reproducible genetic alterations in STS are identified, novel molecular development has been paid attention to identify targets for the application of histology-driven therapy. We herein give an overview of histology-specific chemotherapy for STSs in Japan, highlighting first-line chemotherapy regimens, including molecular-targeted drugs other than doxorubicin- based ones, and introduce the efficacy of trabectedin and eribulin as second-line chemotherapy with consideration of liposarcoma subtypes.