Accelerator Award Protocol - (PANTHR-S)
Research type
Research Study
Full title
Precision medicine approaches for neoadjuvant therapy in high‐risk sarcoma patients (PANTHR-S)
IRAS ID
286407
Contact name
Robin Jones
Contact email
Sponsor organisation
The Royal Marsden NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Recurrence rates for surgically removed soft tissue sarcomas (STS) remain high, novel approaches are required to decrease recurrence and therefore improve outcomes for patients. Chemotherapy prior to surgery (neoadjuvant treatment) has the potential to eliminate early micro-metastatic disease and downstage locally advanced disease to enable complete surgical resection of the tumour. There is no consensus in the existing literature regarding use of neoadjuvant chemotherapy (NCT), and world-wide practice in speciality sarcoma centres is varied. There is a lack of predictive and prognostic biomarkers to identify patients who would benefit most from NCT, both across subtypes and within subtypes. Our collaborative has identified 5 common subtypes of STS to further study in a rational manner to understand their responses to NCT.
This is a tissue based cohort study aimed at developing a stratified medicine approach for personalised NCT in high-risk STS patients with dedifferentiated liposarcoma (DDLPS), leiomyosarcoma (LMS), synovial sarcoma (SS), vascular sarcomas, malignant peripheral nerve sheath tumour (MPNST) or other rare subtypes. It comprises of retrospective and prospective tissue collection from patients advancing directly to surgery (control group) and patients receiving NCT and surgery.
Using prospectively enrolled patients with STS, tissue samples pre-chemotherapy and from surgery will undergo epigenetic, proteomic and genomic profiling to define the biology at two distinct time points. This approach will provide a wealth of data to understand of chemo-sensitivity and resistance. We expect to identify novel biomarkers of NCT response to inform the design of future clinical trials. Tissue samples will be used to develop patient derived models to create a foundation of translational science needed to identify novel therapies and to develop rational to overcome drug resistance. The analysis of digital pathology and imaging data will be used to try and develop a calculation to predict the benefit of neoadjuvant chemotherapy for each patient.
REC name
East of Scotland Research Ethics Service REC 1
REC reference
21/ES/0024
Date of REC Opinion
24 Feb 2021
REC opinion
Favourable Opinion