Sarcomas are cancers of the body’s connective tissues: muscle, fat, bone, cartilage, blood vessels and nerves. There are more than 70 types, and together they make up only about 1 percent of adult cancers, though they are more common in children and young adults. Because they are rare and varied, getting the right diagnosis and treatment depends heavily on experience. This article explains how sarcoma is treated, the landmark German research on hyperthermia, and the newest options for advanced disease.
Why an Expert Sarcoma Center Matters
France built a national network of sarcoma reference centers, called NETSARC, and studied the results. People whose first surgery was done at a reference center lived longer and had fewer recurrences than those operated on elsewhere.1 Expert pathology review is just as important, because sarcoma subtypes are easily confused and the exact type determines treatment.
Surgery and Radiation
The foundation of treatment for localized sarcoma is complete surgical removal with a margin of healthy tissue. For sarcomas of the arms, legs and trunk, radiation before or after surgery lowers the risk of the cancer returning in the same place, often allowing the limb to be saved.
Hyperthermia: The Landmark German Trial
The EORTC 62961 trial, led by Rolf Issels at Ludwig Maximilian University in Munich, enrolled 341 people with high-risk soft-tissue sarcoma. All received chemotherapy before and after surgery, and half also received regional hyperthermia, heating of the tumor area, with each chemotherapy session. Hyperthermia improved control of the tumor and freedom from recurrence, and after ten years, 52.6 percent of those who received hyperthermia were alive, compared with 42.7 percent of those who did not.2 It is one of the strongest randomized trials of any integrative therapy in cancer. See our article on hyperthermia.
Advanced Sarcoma
Chemotherapy. Doxorubicin remains the backbone. In the French LMS-04 trial in leiomyosarcoma, adding trabectedin to doxorubicin doubled the time before the cancer grew, to 12.2 months from 6.2 months.3
Blood vessel blockers. In the European PALETTE trial, pazopanib, a pill that blocks the blood vessels tumors need, extended the time before the cancer grew in many types of advanced soft-tissue sarcoma.4 In China, the similar drug anlotinib is approved for soft-tissue sarcoma after it significantly lengthened the time before the cancer grew compared with placebo.5
Engineered T-cell therapy. Afamitresgene autoleucel reprograms a patient’s own T cells to attack a protein called MAGE-A4. In the SPEARHEAD-1 trial, tumors shrank in about four in ten people with advanced synovial sarcoma, and it was approved in the United States in 2024 as the first engineered T-cell therapy for a solid tumor.6
Targeted and immune therapies for specific subtypes. Gastrointestinal stromal tumors respond to imatinib and related drugs, sarcomas with NTRK gene fusions respond to larotrectinib, and some subtypes, such as alveolar soft part sarcoma, respond to immunotherapy.
Testing the Tumor
Many sarcomas are driven by gene fusions, which are best found with RNA sequencing. Molecular testing confirms the subtype and can reveal targeted options and clinical trials. See our articles on tumor DNA and RNA sequencing and cancer driver pathways.
How Cancer Expert MD Helps
Cancer Expert MD provides education and consultation for people with every type and stage of cancer, and specializes in Stage IV and metastatic cancer. Our guide to what to do when treatment stops working explains re-testing and the next steps, and our book, The New Reality of Cancer, covers testing and treatment across all cancers, including hyperthermia.
Frequently Asked Questions
What is sarcoma?
A cancer of the connective tissues, such as muscle, fat, bone, cartilage, blood vessels or nerves. There are more than 70 types.
Does hyperthermia help sarcoma?
In the German-led EORTC 62961 trial, adding regional hyperthermia to chemotherapy for high-risk soft-tissue sarcoma raised ten-year survival to 52.6 percent, from 42.7 percent.
Should sarcoma be treated at a specialized center?
Yes. A French national study found that people operated on at sarcoma reference centers lived longer and had fewer recurrences.
What are the newest treatments for advanced sarcoma?
Engineered T-cell therapy for synovial sarcoma, doxorubicin with trabectedin for leiomyosarcoma, blood vessel blockers such as pazopanib and anlotinib, and targeted drugs for specific gene changes.
About the author. Dr. Silver, MD, graduated from Temple University School of Medicine, trained as an interventional cardiologist, and has practiced medicine for nearly fifty years. A lymphoma survivor of about twenty-five years, he is co-author, with Dr. Lindmeier, DHSc, of The New Reality of Cancer: The Science of Recovery. Read more about Dr. Silver, MD.
Research by Dr. Lindmeier, DHSc, cancer educator and co-author of The New Reality of Cancer.
This article is for general education only and is not individual medical advice. Always consult your own doctor before making any changes to your care.
© 2026 Cancer Expert MD, Dr. Silver, MD, and Dr. Lindmeier, DHSc. All rights reserved. This article draws on the research in The New Reality of Cancer and may not be copied, republished or distributed without written permission.
For more in-depth information on this topic and many others, get our book, The New Reality of Cancer: The Science of Recovery.
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References
- Blay JY, Honoré C, Stoeckle E, et al. Surgery in reference centers improves survival of sarcoma patients: a nationwide study (NETSARC). Annals of Oncology. 2019.
- Issels RD, Lindner LH, Verweij J, et al. Effect of neoadjuvant chemotherapy plus regional hyperthermia on long-term outcomes among patients with localized high-risk soft tissue sarcoma: the EORTC 62961-ESHO 95 randomized clinical trial. JAMA Oncology. 2018;4(4):483–492.
- Pautier P, Italiano A, Piperno-Neumann S, et al. Doxorubicin alone versus doxorubicin with trabectedin followed by trabectedin alone as first-line therapy for metastatic or unresectable leiomyosarcoma (LMS-04). The Lancet Oncology. 2022;23(8):1044–1054.
- van der Graaf WTA, Blay JY, Chawla SP, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. The Lancet. 2012;379(9829):1879–1886.
- Chi Y, et al. Anlotinib monotherapy for refractory metastatic soft tissue sarcoma (ALTER0203). Journal of Clinical Oncology. 2018;36(15 suppl):11503.
- D’Angelo SP, Araujo DM, Abdul Razak AR, et al. Afamitresgene autoleucel for advanced synovial sarcoma and myxoid round cell liposarcoma (SPEARHEAD-1). The Lancet. 2024;403(10435):1460–1471.
This article is for education only. It is not medical advice and does not diagnose or treat any condition. Cancer Expert MD has no financial relationship with any laboratory, drug maker, supplement company, clinic or hospital.
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