Dr. Singh on the Use of Chemotherapy in Patients With Uterine Leiomyosarcomas

Arun S. Singh, MD, associate professor, Department of Medicine, Division of Hematology/Oncology, University of California, Los Angeles, discusses the use of chemotherapy in patients with uterine leiomyosarcomas.

One of the big areas that really needs better studies to define the optimal treatment is giving chemotherapy in the adjuvant setting, says Singh. Physicians know that most patients who have a uterine leiomyosarcoma have about a 50% to 70% chance of recurrence.

Although it may seem like that’s an easy area to do a clinical trial in, only 2 optimal clinical trials have been done. Singh states that they only enrolled a small number of patients.

There was a trial by the Gynecologic Oncology Group that sought to address this question. However, they had such poor accrual that the trial was closed. Physicians do not really know the answer, says Singh, because they don't have Level I evidence. Therefore, physicians cannot tell patients that chemotherapy is clearly indicated after surgery for uterine leiomyosarcoma. Some of it is currently left to expert opinion.