Pediatric nonrhabdomyosarcoma soft tissue sarcomas

Oncologist

Volumn 13, Issue 6, 2008, Pages 668-678

  Spunt, Sheri L ^a,b   Skapek, Stephen X ^a,b   Coffin, Cheryl M ^c  

^a ST JUDE CHILDREN S RESEARCH HOSPITAL   (United States)

^b UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE   (United States)

^c UNIVERSITY OF UTAH SCHOOL OF MEDICINE   (United States)

Author keywords

Adolescent; Child; Review; Sarcoma; Soft tissue sarcoma

Indexed keywords

AP 23573; BEVACIZUMAB; DOCETAXEL; DOXORUBICIN; FLAVOPIRIDOL; GEMCITABINE; IFOSFAMIDE; IMATINIB; ROMIDEPSIN; SORAFENIB; SUNITINIB; TANESPIMYCIN HYDROQUINONE; TAXANE DERIVATIVE; TRABECTEDIN; TRIPARANOL;

ANGIOSARCOMA; ASPIRATION BIOPSY; BRACHYTHERAPY; CANCER GRADING; CANCER INCIDENCE; CANCER RADIOTHERAPY; CANCER RECURRENCE; CANCER RISK; CANCER STAGING; CANCER SURGERY; CANCER SURVIVAL; CARDIOMYOPATHY; CHONDROSARCOMA; CLINICAL FEATURE; CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; DERMATOFIBROSARCOMA PROTUBERANS; DIAGNOSTIC IMAGING; DRUG TARGETING; FRACTURE; GASTROINTESTINAL STROMAL TUMOR; GASTROINTESTINAL TUMOR; GENETIC ANALYSIS; GROWTH DISORDER; HISTOPATHOLOGY; HUMAN; HYPOGONADISM; IMMUNOPHENOTYPING; INFERTILITY; INTENSITY MODULATED RADIATION THERAPY; KIDNEY DYSFUNCTION; LEIOMYOSARCOMA; LIPOSARCOMA; MEDICAL DECISION MAKING; MICROARRAY ANALYSIS; NEEDLE BIOPSY; NONRHABDOMYOSARCOMA SOFT TISSUE SARCOMA; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOGENESIS; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; PROGNOSIS; RADIATION INJURY; REVIEW; RHABDOMYOSARCOMA; SECOND CANCER; SENTINEL LYMPH NODE BIOPSY; SOFT TISSUE SARCOMA; SYNOVIAL SARCOMA; TREATMENT PLANNING;

CHILD; HUMANS; SARCOMA; SOFT TISSUE NEOPLASMS;

EID: 46149095075     PISSN: 10837159     EISSN: 1549490X     Source Type: Journal    
DOI: 10.1634/theoncologist.2007-0182     Document Type: Review

References (110)

1. Spunt SL, Pappo AS. Childhood nonrhabdomyosarcoma soft tissue sarcomas are not adult-type tumors. J Clin Oncol 2006;24:1958-1959; author reply 1959-1960.
2. Cecchetto G, Carli M, Alaggio R et al. Fibrosarcoma in pediatric patients: Results of the Italian Cooperative Group studies (1979-1995). J Surg Oncol 2001;78:225-231.
3. Ferrari A, Casanova M, Bisogno G et al. Hemangiopericytoma in pediatric ages: A report from the Italian and German Soft Tissue Sarcoma Cooperative Group. Cancer 2001;92:2692-2698.
4. Ries LA, Smith MA, Gurney JG et al. Cancer Incidence and Survival Among Children and Adolescents: United States SEER Program 1975-1995, National Cancer Institute, SEER Program. NIH Pub. No. 99-4649. Bethesda: MD, National Cancer Institute, 1999:1-182.
5. Harms D. Soft tissue sarcomas in the Kiel Pediatric Tumor Registry. Curr Top Pathol 1995;89:31-45.
6. Li FP, Fraumeni JF Jr, Mulvihill JJ et al. A cancer family syndrome in twenty-four kindreds. Cancer Res 1988;48:5358-5362.
7. Kleinerman RA, Tucker MA, Abramson DH et al. Risk of soft tissue sarcomas by individual subtype in survivors of hereditary retinoblastoma. J Natl Cancer Inst 2007;99:24-31.
8. Sørensen SA, Mulvihill JJ, Nielsen A. Long-term follow-up of von Recklinghausen neurofibromatosis. Survival and malignant neoplasms. N Engl J Med 1986;314:1010-1015.
9. Gorlin RJ. Nevoid basal cell carcinoma (Gorlin) syndrome. Genet Med 2004;6:530-539.
10. Goto M, Miller RW, Ishikawa Y et al. Excess of rare cancers in Werner syndrome (adult progeria). Cancer Epidemiol Biomarkers Prev 1996;5:239-246.
11. Henderson TO, Whitton J, Stovall M et al. Secondary sarcomas in childhood cancer survivors: A report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2007;99:300-308.
12. Biggar RJ, Frisch M, Goedert JJ. Risk of cancer in children with AIDS. AIDS-Cancer Match Registry Study Group. JAMA 2000;284:205-209.
13. McClain KL, Leach CT, Jenson HB et al. Association of Epstein-Barr virus with leiomyosarcomas in children with AIDS. N Engl J Med 1995;332:12-18.
14. Stewart FW, Treves N. Classics in oncology: Lymphangiosarcoma in postmastectomy lymphedema: A report of six cases in elephantiasis chirurgica. CA Cancer J Clin 1981;31:284-299.
15. Dich J, Zahm SH, Hanberg A et al. Pesticides and cancer. Cancer Causes Control 1997;8:420-443.
16. Falk H, Herbert J, Crowley S et al. Epidemiology of hepatic angiosarcoma in the United States: 1964-1974. Environ Health Perspect 1981;41:107-113.
17. Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000;100:57-70.
18. Sherr CJ. Principles of tumor suppression. Cell 2004;116:235-246.
19. Haldar M, Hancock JD, Coffin CM et al. A conditional mouse model of synovial sarcoma: Insights into a myogenic origin. Cancer Cell 2007;11:375-388.
20. Keller C, Arenkiel BR, Coffin CM et al. Alveolar rhabdomyosarcomas in conditional Pax3:Fkhr mice: Cooperativity of Ink4a/ARF and Trp53 loss of function. Genes Dev 2004;18:2614-2626.
21. Knezevich SR, McFadden DE, Tao W et al. A novel ETV6-NTRK3 gene fusion in congenital fibrosarcoma. Nat Genet 1998;18:184-187.
22. Duyster J, Bai RY, Morris SW. Translocations involving anaplastic lymphoma kinase (ALK). Oncogene 2001;20:5623-5637.
23. Maire G, Fraitag S, Galmiche L et al. A clinical, histologic, and molecular study of 9 cases of congenital dermatofibrosarcoma protuberans. Arch Dermatol 2007;143:203-210.
24. McArthur GA. Dermatofibrosarcoma protuberans: A surgical disease with a molecular savior. Curr Opin Oncol 2006;18:341-346.
25. Sharpless NE, Ferguson DO, O'Hagan RC et al. Impaired nonhomologous end-joining provokes soft tissue sarcomas harboring chromosomal translocations, amplifications, and deletions. Mol Cell 2001;8:1187-1196.
26. Maser RS, Choudhury B, Campbell PJ et al. Chromosomally unstable mouse tumours have genomic alterations similar to diverse human cancers. Nature 2007;447:966-971.
27. Zhu Y, Ghosh P, Charnay P et al. Neurofibromas in NF1: Schwann cell origin and role of tumor environment. Science 2002;296:920-922.
28. Ponti D, Costa A, Zaffaroni N et al. Isolation and in vitro propagation of tumorigenic breast cancer cells with stem/progenitor cell properties. Cancer Res 2005;65:5506-5511.
29. Xin L, Lawson DA, Witte ON. The Sca-1 cell surface marker enriches for a prostate-regenerating cell subpopulation that can initiate prostate tumorigenesis. Proc Natl Acad Sci U S A 2005;102:6942-6947.
30. Singh SK, Clarke ID, Terasaki M et al. Identification of a cancer stem cell in human brain tumors. Cancer Res 2003;63:5821-5828.
31. Wu C, Wei Q, Utomo V et al. Side population cells isolated from mesenchymal neoplasms have tumor initiating potential. Cancer Res 2007;67:8216-8222.
32. Fletcher CD, Unni KK, Mertens F. Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon, France: IARC Press, 2002:1-427.
33. Coffin CM, Dehner LP. Pathologic evaluation of pediatric soft tissue tumors. Am J Clin Pathol 1998;109(suppl 1):S38-S52.
34. Coffin CM. Pediatric Soft Tissue Tumors. A Clinical, Pathological, and Therapeutic Approach. St. Louis: Williams & Wilkins, 1997:1-400.
35. Antonescu CR. The role of genetic testing in soft tissue sarcoma. Histopathology 2006;48:13-21.
36. West RB, van de Rijn M. The role of microarray technologies in the study of soft tissue tumours. Histopathology 2006;48:22-31.
37. McManus AP, Gusterson BA, Pinkerton CR et al. The molecular pathology of small round-cell tumours - relevance to diagnosis, prognosis, and classification. J Pathol 1996;178:116-121.
38. Oliveira AM, Fletcher CD. Molecular prognostication for soft tissue sarcomas: Are we ready yet? J Clin Oncol 2004;22:4031-4034.
39. Weiss SW, Goldblum JR. Enziger and Weiss's Soft Tissue Tumors. St. Louis: Mosby, 2001:1-1622.
40. Parham DM, Webber BL, Jenkins JJ et al. Nonrhabdomyosarcomatous soft tissue sarcomas of childhood: Formulation of a simplified system for grading. Mod Pathol 1995;8:705-710.
41. Arbiser ZK, Folpe AL, Weiss SW. Consultative (expert) second opinions in soft tissue pathology. Analysis of problem-prone diagnostic situations. Am J Clin Pathol 2001;116:473-476.
42. Hasegawa T, Yamamoto S, Nojima T et al. Validity and reproducibility of histologic diagnosis and grading for adult soft-tissue sarcomas. Hum Pathol 2002;33:111-115.
43. Haimi M, Peretz Nahum M, Ben Arush MW. Delay in diagnosis of children with cancer: A retrospective study of 315 children. Pediatr Hematol Oncol 2004;21:37-48.
44. Pappo AS, Rao BN, Jenkins JJ et al. Metastatic nonrhabdomyosarcomatous soft-tissue sarcomas in children and adolescents: The St. Jude Children's Research Hospital experience. Med Pediatr Oncol 1999;33:76-82.
45. Fong Y, Coit DG, Woodruff JM et al. Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 1993;217:72-77.
46. Heslin MJ, Lewis JJ, Woodruff JM et al. Core needle biopsy for diagnosis of extremity soft tissue sarcoma. Ann Surg Oncol 1997;4:425-431.
47. Miralles TG, Gosalbez F, Menéndez P et al. Fine needle aspiration cytology of soft-tissue lesions. Acta Cytol 1986;30:671-678.
48. Paganelli G, De Cicco C, Chinol M. Sentinel node localization by lymphoscintigraphy: A reliable technique with widespread applications. Recent Results Cancer Res 2000;157:121-129.
49. Fleming JB, Cantor SB, Varma DG et al. Utility of chest computed tomography for staging in patients with T1 extremity soft tissue sarcomas. Cancer 2001;92:863-868.
50. Jager PL, Hoekstra HJ, Leeuw J et al. Routine bone scintigraphy in primary staging of soft tissue sarcoma: Is it worthwhile? Cancer 2000;89:1726-1731.
51. Espat NJ, Bilsky M, Lewis JJ et al. Soft tissue sarcoma brain metastases. Prevalence in a cohort of 3829 patients. Cancer 2002;94:2706-2711.
52. Pappo AS, Devidas M, Jenkins J et al. Phase II trial of neoadjuvant vincristine, ifosfamide, and doxorubicin with granulocyte colony-stimulating factor support in children and adolescents with advanced-stage nonrhabdomyosarcomatous soft tissue sarcomas: A Pediatric Oncology Group Study. J Clin Oncol 2005;23:4031-4038.
53. Pratt CB, Maurer HM, Gieser P et al. Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy: A Pediatric Oncology Group study. Med Pediatr Oncol 1998;30:201-209.
54. Pratt CB, Pappo AS, Gieser P et al. Role of adjuvant chemotherapy in the treatment of surgically resected pediatric nonrhabdomyosarcomatous soft tissue sarcomas: A Pediatric Oncology Group Study. J Clin Oncol 1999;17:1219.
55. Ferrari A, Casanova M, Collini P et al. Adult-type soft tissue sarcomas in pediatric-age patients: Experience at the Istituto Nazionale Tumori in Milan. J Clin Oncol 2005;23:4021-4030.
56. Spunt SL, Poquette CA, Hurt YS et al. Prognostic factors for children and adolescents with surgically resected nonrhabdomyosarcoma soft tissue sarcoma: An analysis of 121 patients treated at St Jude Children's Research Hospital. J Clin Oncol 1999;17:3697-3705.
57. Spunt SL, Hill DA, Motosue AM et al. Clinical features and outcome of initially unresected nonmetastatic pediatric nonrhabdomyosarcoma soft tissue sarcoma. J Clin Oncol 2002;20:3225-3235.
58. Pisters PW, Leung DH, Woodruff J et al. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol 1996;14:1679-1689.
59. Maurer HM, Beltangady M, Gehan EA et al. The Intergroup Rhabdomyosarcoma Study-I. A final report. Cancer 1988;61:209-220.
60. American Joint Committee on Cancer. AJCC Cancer Staging Handbook. New York: Springer, 2002:1-469.
61. Hajdu SI, Shiu MH, Brennan MF. The role of the pathologist in the management of soft tissue sarcomas. World J Surg 1988;12:326-331.
62. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res 2003;415:4-18.
63. Wunder JS, Healey JH, Davis AM et al. A comparison of staging systems for localized extremity soft tissue sarcoma. Cancer 2000;88:2721-2730.
64. Costa J, Wesley RA, Glatstein E et al. The grading of soft tissue sarcomas. Results of a clinicohistopathologic correlation in a series of 163 cases. Cancer 1984;53:530-541.
65. Guillou L, Coindre JM, Bonichon F et al. Comparative study of the National Cancer Institute and French Federation of Cancer Centers Sarcoma Group grading systems in a population of 410 adult patients with soft tissue sarcoma. J Clin Oncol 1997;15:350-362.
66. Hudson MM, Tyc VL, Cremer LK et al. Patient satisfaction after limb-sparing surgery and amputation for pediatric malignant bone tumors. J Pediatr Oncol Nurs 1998;15:60-69; discussion 70-71.
67. Rosenberg SA, Tepper J, Glatstein E et al. The treatment of soft-tissue sarcomas of the extremities: Prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 1982;196:305-315.
68. Baldini EH, Goldberg J, Jenner C et al. Long-term outcomes after function-sparing surgery without radiotherapy for soft tissue sarcoma of the extremities and trunk. J Clin Oncol 1999;17:3252-3259.
69. Rydholm A, Gustafson P, Rööser B et al. Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma. J Clin Oncol 1991;9:1757-1765.
70. Brennan MF. The enigma of local recurrence. The Society of Surgical Oncology. Ann Surg Oncol 1997;4:1-12.
71. Girard P, Spaggiari L, Baldeyrou P et al. Should the number of pulmonary metastases influence the surgical decision? Eur J Cardiothorac Surg 1997;12:385-391; discussion 392.
72. Kepka L, DeLaney TF, Suit HD et al. Results of radiation therapy for unresected soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 2005;63:852-859.
73. Yang JC, Chang AE, Baker AR et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998;16:197-203.
74. Kraybill WG, Harris J, Spiro IJ et al. Phase II study of neoadjuvant chemotherapy and radiation therapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514. J Clin Oncol 2006;24:619-625.
75. DeLaney TF, Spiro IJ, Suit HD et al. Neoadjuvant chemotherapy and radiotherapy for large extremity soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 2003;56:1117-1127.
76. O'Sullivan B, Davis AM, Turcotte R et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: A randomised trial. Lancet 2002;359:2235-2241.
77. Alektiar KM, Hu K, Anderson L et al. High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas. Int J Radiat Oncol Biol Phys 2000;47:157-163.
78. Nag S, Tippin D, Ruymann FB. Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: The Ohio State University experience. Int J Radiat Oncol Biol Phys 2001;51:729-735.
79. Laskar S, Bahl G, Ann Muckaden M et al. Interstitial brachytherapy for childhood soft tissue sarcoma. Pediatr Blood Cancer 2007;49:649-655.
80. Wolden SL, Wexler LH, Kraus DH et al. Intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma. Int J Radiat Oncol Biol Phys 2005;61:1432-1438.
81. Luu QT, Loredo LN, Archambeau JO et al. Fractionated proton radiation treatment for pediatric craniopharyngioma: Preliminary report. Cancer J 2006;12:155-159.
82. Hug EB, Muenter MW, Archambeau JO et al. Conformal proton radiation therapy for pediatric low-grade astrocytomas. Strahlenther Onkol 2002;178:10-17.
83. Yock T, Schneider R, Friedmann A et al. Proton radiotherapy for orbital rhabdomyosarcoma: Clinical outcome and a dosimetric comparison with photons. Int J Radiat Oncol Biol Phys 2005;63:1161-1168.
84. Bramwell VH. Adjuvant chemotherapy for adult soft tissue sarcoma: Is there a standard of care? J Clin Oncol 2001;19:1235-1237.
85. Frustaci S, Gherlinzoni F, De Paoli A et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: Results of the Italian randomized cooperative trial. J Clin Oncol 2001;19:1238-1247.
86. Demetri GD, Elias AD. Results of single-agent and combination chemotherapy for advanced soft tissue sarcomas. Implications for decision making in the clinic. Hematol Oncol Clin North Am 1995;9:765-785.
87. Patel SR, Vadhan-Raj S, Burgess MA et al. Results of two consecutive trials of dose-intensive chemotherapy with doxorubicin and ifosfamide in patients with sarcomas. Am J Clin Oncol 1998;21:317-321.
88. Von Burton G, Rankin C, Zalupski MM et al. Phase II trial of gemcitabine as first line chemotherapy in patients with metastatic or unresectable soft tissue sarcoma. Am J Clin Oncol 2006;29:59-61.
89. Köstler WJ, Brodowicz T, Attems Y et al. Docetaxel as rescue medication in anthracycline- and ifosfamide-resistant locally advanced or metastatic soft tissue sarcoma: Results of a phase II trial. Ann Oncol 2001;12:1281-1288.
90. Hensley ML, Maki R, Venkatraman E et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: Results of a phase II trial. J Clin Oncol 2002;20:2824-2831.
91. Maki RG, Wathen JK, Patel SR et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: Results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol 2007;25:2755-2763.
92. Fata F, O'Reilly E, Ilson D et al. Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face. Cancer 1999;86:2034-2037.
93. Reichardt P. High-dose chemotherapy in adult soft tissue sarcoma. Crit Rev Oncol Hematol 2002;41:157-167.
94. Weiser MR, Downey RJ, Leung DH et al. Repeat resection of pulmonary metastases in patients with soft-tissue sarcoma. J Am Coll Surg 2000;191:184-190; discussion 190-191.
95. Paulides M, Kremers A, Stöhr W et al. Prospective longitudinal evaluation of doxorubicin-induced cardiomyopathy in sarcoma patients: A report of the late effects surveillance system (LESS). Pediatr Blood Cancer 2006;46:489-495.
96. Stöhr W, Paulides M, Bielack S et al. Ifosfamide-induced nephrotoxicity in 593 sarcoma patients: A report from the Late Effects Surveillance System. Pediatr Blood Cancer 2007;48:447-452.
97. Bacci G, Ferrari S, Bertoni F et al. Long-term outcome for patients with nonmetastatic osteosarcoma of the extremity treated at the Istituto Ortopedico Rizzoli according to the Istituto Ortopedico Rizzoli/osteosarcoma-2 protocol: An updated report. J Clin Oncol 2000;18:4016-4027.
98. Heinrich MC, Corless CL, Demetri GD et al. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 2003;21:4342-4349.
99. Demetri GD, van Oosterom AT, Garrett CR et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: A randomised controlled trial. Lancet 2006;368:1329-1338.
100. McArthur GA, Demetri GD, van Oosterom A et al. Molecular and clinical analysis of locally advanced dermatofibrosarcoma protuberans treated with imatinib: Imatinib Target Exploration Consortium Study B2225. J Clin Oncol 2005;23:866-873.
101. D'Adamo DR, Keohan M, Schuetze S et al. Clinical results of a phase II study of sorafenib in patients (pts) with non-GIST sarcomas (CTEP study #7060). J Clin Oncol 2007;25(18 suppl):545s.
102. Bauer S, Yu LK, Demetri GD et al. Heat shock protein 90 inhibition in imatinib-resistant gastrointestinal stromal tumor. Cancer Res 2006;66:9153-9161.
103. Terry J, Lubieniecka JM, Kwan W et al. Hsp90 inhibitor 17-allylamino-17-demethoxygeldanamycin prevents synovial sarcoma proliferation via apoptosis in in vitro models. Clin Cancer Res 2005;11:5631-5638.
104. Sambol EB, Ambrosini G, Geha RC et al. Flavopiridol targets c-KIT transcription and induces apoptosis in gastrointestinal stromal tumor cells. Cancer Res 2006;66:5858-5866.
105. Chawla SP, Tolcher AW, Staddon AP et al. Survival results with AP23573, a novel mTOR inhibitor, in patients (pts) with advanced soft tissue or bone sarcomas: Update of phase II trial. J Clin Oncol 2007;25(18 suppl):563s.
106. Okuno S. Mammalian target of rapamycin inhibitors in sarcomas. Curr Opin Oncol 2006;18:360-362.
107. D'Adamo DR, Anderson SE, Albritton K et al. Phase II study of doxorubicin and bevacizumab for patients with metastatic soft-tissue sarcomas. J Clin Oncol 2005;23:7135-7142.
108. Tiet TD, Hopyan S, Nadesan P et al. Constitutive hedgehog signaling in chondrosarcoma up-regulates tumor cell proliferation. Am J Pathol 2006;168:321-330.
109. Ito T, Ouchida M, Morimoto Y et al. Significant growth suppression of synovial sarcomas by the histone deacetylase inhibitor FK228 in vitro and in vivo. Cancer Lett 2005;224:311-319.
110. Huygh G, Clement PM, Dumez H et al. Ecteinascidin-743: Evidence of activity in advanced, pretreated soft tissue and bone sarcoma patients. Sarcoma 2006;2006:56282.