Sarcoma Clinical Trials

About Sarcoma trials

Sarcoma is a family of more than 70 distinct cancers arising from mesenchymal tissues, and trials are heavily subtype-specific rather than treating "sarcoma" as a single disease. The major soft tissue sarcoma subtypes include leiomyosarcoma (LMS), well-differentiated and dedifferentiated liposarcoma (WDLS / DDLS), undifferentiated pleomorphic sarcoma (UPS), synovial sarcoma, myxoid liposarcoma, malignant peripheral nerve sheath tumor (MPNST), and rare specific entities. GIST has its own dedicated trial-finder page. CDK4 and MDM2 amplification together identify well-differentiated and dedifferentiated liposarcoma, gating CDK4/6 inhibitor and MDM2 inhibitor trials. SS18 (the SS18-SSX fusion) identifies synovial sarcoma and is the basis for cell therapy trials including engineered T-cell receptor (TCR-T) approaches. NTRK fusions (NTRK1, NTRK2, NTRK3) are rare in adult sarcoma but actionable for tumor-agnostic NTRK trials when present. TP53 and RB1 alterations provide tumor suppressor context that contributes to trial stratification rather than determining direct eligibility.

Recruiting trials cluster by subtype and treatment line. Leiomyosarcoma trials test new combinations on the doxorubicin or doxorubicin + ifosfamide backbone in front-line, gemcitabine + docetaxel and trabectedin in second-line, and novel mechanisms in later lines. Well-differentiated and dedifferentiated liposarcoma trials test CDK4/6 inhibitors, MDM2 inhibitors, and combinations targeting their characteristic amplifications. Synovial sarcoma trials test cell therapy approaches, particularly MAGE-A4-directed TCR-T (afamitresgene autoleucel, for HLA-A02-positive patients; SS18-SSX fusion confirms the diagnosis but is not the TCR-T target) and novel engineered cell therapies. UPS trials test IO combinations, with some response signal in undifferentiated pleomorphic sarcoma compared to other STS subtypes. Anti-PD1 / anti-CTLA4 sarcoma trials enroll across subtypes with subtype stratification. Novel mechanism trials (HDAC inhibitors, EZH2 inhibitors for MPNST and epithelioid sarcoma, anti-AXL agents) are common in later-line settings. Pediatric and young adult sarcomas (Ewing sarcoma, alveolar soft part sarcoma, etc.) often run through cooperative-group networks separately from adult sarcoma trials.

Sarcoma trial coordinators typically ask about subtype, prior anthracycline exposure, and HLA typing for cell therapy trials. Histologic subtype confirmation by central pathology review is foundational because most trials are subtype-restricted. Prior anthracycline exposure (doxorubicin or doxorubicin + ifosfamide) is the standard front-line for metastatic sarcoma, and most trials are line-defined relative to it. Prior gemcitabine + docetaxel and trabectedin exposure matter for line-specific trials. For synovial sarcoma TCR-T trials: HLA-A02 positivity and SS18-SSX fusion confirmation are required; the TCR-T target is MAGE-A4, not SS18-SSX. CDK4 and MDM2 amplification testing for liposarcoma-targeted trials. Performance status, with most trials accepting ECOG 0-1, sometimes ECOG 2 for second-line trials. Subtype-specific eligibility details: well-differentiated vs dedifferentiated liposarcoma boundary (some trials accept both, others one or the other), grade for soft tissue sarcoma (FNCLCC grade), and tumor measurability by RECIST.

Biomarkers tested in Sarcoma trials

These are the molecular markers most commonly required or evaluated in Sarcoma eligibility criteria. OncoMatch extracts them from each trial's protocol and matches them against your test results.