Uterine Leiomyosarcoma

P2, N=23, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Mar 2026 --> Nov 2026

ATRX status may serve as a potential biomarker for prognosis and therapeutic stratification. Future clinical trials investigating epigenetic therapies could offer novel treatment strategies for ATRX-deficient sarcomas.

In cancer treatment, contrast-enhanced MRI is useful for identifying the size and location of tumor masses. However, contrast-enhanced MRI does not lead to the diagnosis of tumor masses. Therefore, early blood tests and tumor biopsy results are important for differential diagnosis and early treatment decisions.

Emerging therapeutic approaches aim to restore the tumor-suppressive miRNAs or inhibit oncogenic ones using mimics or antagomiRs. Overall miRNAs represent critical regulators of uLMS pathogenesis and hold significant potential for precision diagnosis, prognostication, and targeted therapy, though larger validation studies and improved delivery systems are required before clinical translation.

P2, N=17, Active, not recruiting, Stanford University | Recruiting --> Active, not recruiting | N=25 --> 17 | Trial completion date: Dec 2025 --> May 2026 | Trial primary completion date: Dec 2025 --> May 2026

Accurate recognition of IMT with unusual features is crucial for targeted treatment. ALK protein expression and molecular testing play critical roles in diagnosis and differential diagnosis, and lowering the detection threshold to improve sensitivity is urgently needed.

Our results reveal molecular heterogeneity in uterine leiomyosarcomas and provide potential diagnostic and prognostic biomarkers for improved patient management.

Molecular profiling of uLMS has also uncovered possible therapeutic targets in the most common type of uterine sarcoma, where prognostication and clinical management remain challenging. This review discusses the current histologic and molecular classification of low- and high-grade ESS, FUS, and conventional and variant uLMS and explores the potential impact of the genetic alterations observed in these uterine sarcomas on treatment.

Primary uLMS and subsequent recurrences display genomic intra-individual concordance, with sustained driver cancer gene alterations over time. Chromosomal instability was higher in recurrent tumors.

ER and PR were both completely negative in all 8 cases of retroperitoneal LMS and were both strongly expressed in all 6 cases of LM with bizarre nuclei. In conclusion, despite conflicting data in the literature regarding the utility of ER and PR in distinguishing uterine versus extrauterine smooth muscle tumors, we endorse the use of these markers for the specific distinction of retroperitoneal LMS with symplastic-like features from disseminated uterine LM with bizarre nuclei in female patients.

The case report shows the high value of systematic molecular sequencing of cancer tissue and presentation in molecular tumor board for identification of molecular target structures for optimized palliative systemic therapy of metastatic leiomyosarcoma. In addition, the case report demonstrates that the combination therapy olaparib/temozolomide may also be an effective treatment approach for nonuterine leiomyosarcoma with HRR loss of function.

Although the recovery immediately following surgery was smooth and without complications, the dog's condition worsened over the following month, ultimately leading to euthanasia. This report describes the histopathologic features and clinical outcome of an unusual variant of uterine leiomyosarcoma in a dog.