Trabectedin Myxoid Liposarcoma — SCE Medical Oncology MCQ
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Correct answer: D — Weekly paclitaxel after sarcoma-MDT confirmation of cutaneous scalp angiosarcoma
Weekly paclitaxel has particular clinical activity in multifocal cutaneous angiosarcoma of the scalp and is a standard specialist option. Liposomal doxorubicin after sarcoma-MDT confirmation of cutaneous scalp angiosarcoma: anthracyclines are active, but weekly paclitaxel has particular activity in scalp angiosarcoma. Gemcitabine-docetaxel after sarcoma-MDT confirmation of cutaneous scalp angiosarcoma: this is a reasonable sarcoma regimen but not the particularly subtype-active choice. Pazopanib after sarcoma-MDT confirmation of cutaneous scalp angiosarcoma: pazopanib is a later antiangiogenic option rather than the characteristic initial cytotoxic choice. Pembrolizumab after sarcoma-MDT confirmation of cutaneous scalp angiosarcoma: immunotherapy can be considered in selected disease but is not the standard answer absent a biomarker or access context.
Reference: ANGIOTAX phase II trial of weekly paclitaxel for unresectable angiosarcoma (Published 2008): https://pubmed.ncbi.nlm.nih.gov/18809609/; Comparison of doxorubicin and weekly paclitaxel efficacy in metastatic angiosarcoma (Published July 2012): https://pubmed.ncbi.nlm.nih.gov/22045619/; British Sarcoma Group clinical practice guideline for soft-tissue sarcoma (Published May 2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC11724041/; NICE QS78 sarcoma quality standard (Published January 2015; current NICE quality standard): https://www.nice.org.uk/guidance/qs78