Sylvie Bonvalot, MD, PhD, Discusses Selecting Patients With Locally Advanced Sarcoma for Pre and Postoperative Treatment


CancerNetwork® sat down with Sylvie Bonvalot, MD, PhD, at the 2021 ASCO Annual Meeting to talk about treatment options for high-grade or grade II sarcoma.

At the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® spoke with Sylvie Bonvalot, MD, PhD, from Institut Curie, about standard of care and treatment options for patients with high-grade or grade II sarcoma.

Bonvalot discusses a phase 2/3 trial (NCT02379845) that used the radioenhancer NBTXR3 as a preoperative treatment to radiotherapy for high-grade sarcoma. The findings of this study were positive and reinforced the use of NBTXR3 in patients with locally advanced soft tissue sarcoma.1 In her discussion, she talks about leaning on colleagues across multidisciplinary oncology teams to select patients who are appropriate for treatment.


In locally advanced sarcoma of at least high-grade or grade 2 [disease], the standard treatment is surgery and radiotherapy and more and more of this [is by] local treatment. Radiotherapy is delivered preoperatively because the long-term morbidity is lower than postoperative therapy. There was a trial run by O’Sullivan a few years ago and clearly preoperative radiotherapy had a better outcome in the long term; [however] you cannot do that for everyone.2

When there was indication and sufficient fit for appropriate radiotherapy, we do more of the radiotherapy postoperatively. This is for high-grade locally advanced sarcoma. Concerning chemotherapy, it’s not standard of care. They would debate, it depends on the subtype, but neoadjuvant chemotherapy is still an option in the guidelines; it’s not always the patient. Usually for grade II or III locally advanced sarcoma, standard of care is a radiotherapy and surgery and the option is a chemotherapy for a subgroup of patients with specific subtype, [such as a] young patient because classically it is a little bit difficult for elderly patients. It’s not the standard of care to deliver the chemotherapy for outpatient surgeries and why the standard is radiotherapy and surgery. In this trial we did, we’re discussing [patients] in the multi-disciplinary tumor board. When it was a locally advanced high-grade sarcoma, the conclusion was radiotherapy and surgery, and the trial was proposed to the patient.


1. Bonvalot S, Rutkowski P, Thariat J, et al. Long-term evaluation of the novel radioenhancer NBTXR3 plus radiotherapy in patients with locally advanced soft tissue sarcoma treated in the phase II/II Act.In.Sarc trial. . J Clin Oncol. 2021; 39(suppl 15):11544. 10.1200/JCO.2021.39.15_suppl.11544

2. 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(9325):2235-2241. doi:10.1016/S0140-6736(02)09292-9

Related Videos
Collaboration among nurses, social workers, and others may help in safely administering outpatient bispecific T-cell engager therapy to patients.
Nurses should be educated on cranial nerve impairment that may affect those with multiple myeloma who receive cilta-cel, says Leslie Bennett, MSN, RN.
Treatment with cilta-cel may give patients with multiple myeloma “more time,” according to Ishmael Applewhite, BSN, RN-BC, OCN.
Nurses may need to help patients with multiple myeloma adjust to walking differently in the event of peripheral neuropathy following cilta-cel.
Tailoring neoadjuvant therapy regimens for patients with mismatch repair deficient gastroesophageal cancer represents a future step in terms of research.
Not much is currently known about the factors that may predict pathologic responses to neoadjuvant immunotherapy in this population, says Adrienne Bruce Shannon, MD.
Data highlight that patients who are in Black and poor majority areas are less likely to receive liver ablation or colorectal liver metastasis in surgical cancer care.
Findings highlight how systemic issues may impact disparities in outcomes following surgery for patients with cancer, according to Muhammad Talha Waheed, MD.
Pegulicianine-guided breast cancer surgery may allow practices to de-escalate subsequent radiotherapy, says Barbara Smith, MD, PhD.
Adrienne Bruce Shannon, MD, discussed ways to improve treatment and surgical outcomes for patients with dMMR gastroesophageal cancer.
Related Content