MUSC background

Innovative Treatments for Sarcoma at MUSC

The Hollings Cancer Center (HCC) at the Medical University of South Carolina (MUSC) is one of 68 National Cancer Institute (NCI)-designated cancer centers in the nation. As such, the Center combines the full range of cancer treatment specialties with a transdisciplinary research environment and training for specialists and scientists, all of which make the Hollings Cancer Center one of the leading cancer treatment centers in the Southeast. 

Among the rarest of cancers are sarcomas.  Approximately 14,000 new cases are diagnosed each year in the United States.  At the HCC, sarcomas represent 1% of all adult malignancies. 

Since 2009, MUSC has been building the Sarcoma Program and today it is one of the few in the Southeast that offers a multidisciplinary, sarcoma-specific tumor board at an NCI-designated center. 

Lee Leddy, M.D., one of two orthopedic oncologists in South Carolina, and Andrew Kraft, M.D., the William H. Folk Chair in Medical Oncology and Director of the HCC, lead the team of specialists who design an optimal combination of surgery, radiation therapy, chemotherapy, and palliative care for sarcoma patients.  In addition, Dr. Kraft directs several clinical trials to investigate new ways to enhance patient care.

Dr. Leddy’s specific training and expertise is crucial to diagnosing malignancy accurately.  According to the American Cancer Society, it is particularly important that a qualified orthopedic oncologist perform biopsies for osteosarcoma (bone cancer) for “in no other cancer is it as important to perform this procedure properly.  An improperly performed biopsy may make it difficult to save the affected limb from amputation."

Among the Sarcoma Program’s significant accomplishments is the first implantation in South Carolina of an expandable prosthesis—a device implanted by Dr. Leddy in the femur of a nine-year-old boy with a distal femoral osteosarcoma.   Because the femur is a growth plate, the tumor would have affected the growth of his leg.  The prosthesis contains a magnet that will expand the prosthesis when the leg is periodically placed adjacent to another specialized magnet.  This and other technologies enable surgeons to minimize amputations, says Dr. Leddy. “In 85% to 90% of cases, when we work with our colleagues in medical oncology and radiation oncology, we can salvage a functional limb.” 

Approximately 30% of Dr. Leddy’s patients are under 18 years of age and the majority are sarcoma patients.  In adults, he also treats many other kinds of cancer (eg, breast, lung, and kidney) that have metastasized to bone. 

Surgery is just one aspect of sarcoma patient care.  As Director of the Hollings Cancer Center, Dr. Kraft oversees a team of specialists who provide all modalities of cancer treatment.  He also oversees a portfolio of clinical trials that offer the latest options for most types of cancer.  Of the sarcoma trials, two trials for patients with advanced soft tissue sarcoma are of particular significance.

In one study, investigators are evaluating the safety of the experimental drug Yondelis (trabectedin) in adult patients with soft tissue sarcomas who have not responded to previous treatment.  This drug is approved for use in other countries and, pending the outcome of this trial and of other trials involving Yondelis underway around the country, could be approved for use in the United States by the Food and Drug Administration.

In another study, the researchers are studying two combinations of drugs (gemcitabine plus pazopanib and gemcitabine plus docetaxel) in patients with previously treated and/or locally advanced or recurrent soft tissue sarcoma.  In this trial, pazopanib, one of the first tyrosine kinase inhibitors to show efficacy in phase 2 and phase 3 studies, is combined with cytotoxic chemotherapy to assess the effectiveness of this combination regimen against the current standard of care. 

Both of these studies are currently recruiting patients. The pazopanib trial is notable as it was locally developed by Dr. Kraft, and MUSC serves as the coordinating center.  Five other academic centers are participating in this trial (Johns Hopkins, University of Maryland, M.D.  Anderson, the University of Colorado, and the University of Texas Health Sciences Center). 

For more information on these trials, call MEDULINE at 1-800-922-5250 or 843-792-2200 and ask for Susan Shannon, CCRC, Clinical Operations Manager at Hollings Cancer Center, or visit http://hcc.musc.edu/clinicaltrials.