Uterine leiomyosarcoma
Shout out to Dr. Monk who is the first author on this study!
Uterine leiomyosarcoma (uLMS) is a rare, aggressive uterine malignancy with a 5-year OS ranging from 51–76% in FIGO stage I to just 10–15% in stage IV, and a median OS of 10 months for advanced disease. The mainstay of treatment for localized disease is en-bloc TH ± BSO, with observation recommended postoperatively for stage I; adjuvant chemo or RT has not shown a clear survival benefit in early-stage disease. For advanced or unresectable cases, doxorubicin-based regimens (± trabectedin) remain standard, but even with multimodal therapy, outcomes remain poor (5-year recurrence 40–75%, 70% distant). Novel strategies—anti-angiogenics, ICIs, PARP inhibitors—are under investigation, but robust data are lacking. Bottom line: uLMS continues to challenge us with its aggressive biology and limited therapeutic gains, so we need to keep pushing for trial enrollment and molecularly targeted approaches.