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Targeting Treatment of Soft Tissue Sarcomas (Cancer Treatment and Research)

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The last decade we have witnessed a major change in the development of new techniques and agents for the treatment of cancer in general, and for soft tissue sarcomas in particular. The important achievements of molecular biology research have changed the landscape markedly. Increasingly subtypes of soft tissue sarcomas are shown to be related to changes in cellular growth factors in the cell signaling pathways. This in theory enabled to development of agents with specific activity against these factors. The presence of the KIT receptor at the surface of the gastrointestinal stroma tumor cell, and the constitutive activation by mutations, has lead to the discovery of the specific KIT tyrosine kinase inhibitor Imatinib, an agent with impressive activity in this disease. Before the era of Imatinib, GIST was an untreatable disease once metastasized. Imatinib clearly is a breakthrough in the approach of soft tissue sarcomas, and will likely serve as a role model for the development of other agents acting towards other receptors. Likewise, soft tissue sarcomas with their specific molecular characteristics, will likely serve as role model diseases for targeted treatment approaches. Whether the future lies in drugs with selective inhibition of only one receptor and one pathway, or multiple receptors and multiple pathways is currently a matter of debate, and again soft tissue sarcomas serve as role model.

Fully in line with the more targeted approach in drug use, the changes in the field of radiation therapy and surgery basically also focus on a better targeting of the disease, albeit not based on the molecular characteristics yet.

The present volume of this series reflects all of the above mentioned changes. World wide renowned experts have been willing to contribute to this book, and we would like to thank all of them for their efforts. Hopefully this book will contribute to a better understanding of the changes in the field, and will serve our patients in helping getting a better future.
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