Where soft tissue sarcoma treatment is heading

About 13,000 people in the US are diagnosed with soft tissue sarcoma each year, cancers that start in fat, muscle, nerves or other connective tissue. There are more than 50 subtypes, and each behaves differently. Surgery, often with radiation, cures many localized cases. For advanced disease, doxorubicin-based chemotherapy has been the backbone for decades, but subtype-specific drugs, immunotherapy and engineered T cells are now changing that.

• 228studies open or running
• 11phase 3 trials
• 1,413papers published this year
• 40NIH-funded projects

1. Now

   Nov 2026

   A survival gain in leiomyosarcomaHappened 33 mo median survival

   Doxorubicin plus trabectedin: median survival 33 vs 24 months with doxorubicin alone.

   33 mo: median survival, vs 24 months with doxorubicin alone.

   • LMS-04 trial

   Immunotherapy around surgeryHappened 67% disease-free at 2 years

   Adding pembrolizumab to radiation and surgery for high-risk limb sarcomas: 67% disease-free at 2 years vs 52%.

   67%: disease-free at 2 years, vs 52% without pembrolizumab.

   • SU2C-SARC032 trial

   The first engineered T-cell therapy for a solid tumorHappened 39% response rate

   Afami-cel shrank tumors in 39% of people with synovial sarcoma; accelerated approval August 2024.

   39%: response rate in synovial sarcoma.

   • SPEARHEAD-1 trial

2. 6 months

   by May 2027

   Who should get chemotherapy after surgeryLikely 0.80 hazard ratio for death

   Pooled trials show a 20% lower risk of death with chemotherapy after surgery; guidelines continue to narrow who benefits most.

   0.80: hazard ratio for death with chemotherapy after surgery.

   • Adjuvant chemotherapy meta-analysis

3. 12 months

   by Nov 2027

   A drug injected directly into tumorsPossible

   INVINCIBLE-3 (333 people) compares INT230-6, injected into tumors, with standard second-line treatment; due December 2027.

   • INVINCIBLE-3

4. 3 years

   by late 2029

   Shorter radiation before surgeryPossible

   A SWOG trial (296 people) compares 5 days of radiation with the standard 5 weeks; due April 2029.

   • SWOG radiation trial

   Immunotherapy plus targeted pills for liposarcomaLong shot

   An Alliance trial adds cemiplimab to palbociclib for dedifferentiated liposarcoma; due April 2028.

   • Alliance liposarcoma trial

5. 5 years

   by late 2031

   Immunotherapy with first-line chemotherapyPossible 67% disease-free (SARC032)

   A National Cancer Institute trial (365 people) tests adding immunotherapy to chemotherapy for advanced sarcoma; due April 2032.

   67%: disease-free at 2 years, vs 52% without pembrolizumab.

   • SU2C-SARC032 trial
   • NCI immunotherapy trial

   Using a tumor gene signature to choose chemotherapyLong shot

   CHIC-STS01 (600 people) gives chemotherapy around surgery only to tumors flagged high-risk by the CINSARC gene test; due October 2032.

   • CHIC-STS01

The research paths

Borrowed from other cancers

Open to join now

• Advanced sarcoma

  Immunotherapy plus chemotherapy

  Phase 3 · 269 sites

  Locations and eligibility →

• Localized, before surgery

  Short-course radiation

  Phase 3 · 67 sites

  Locations and eligibility →

• Advanced, after chemotherapy

  INT230-6 intratumoral injection

  Phase 3 · 17 sites

  Locations and eligibility →

See every recruiting Soft tissue sarcoma trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• Localized, removableSurgery, usually with radiation before or after; chemotherapy for some high-risk tumors.
• Locally advancedRadiation and/or chemotherapy before surgery; immunotherapy added for some subtypes in trials.
• Advanced or metastaticDoxorubicin-based chemotherapy; doxorubicin plus trabectedin for leiomyosarcoma.
• After first-line chemotherapySubtype-specific options: trabectedin, eribulin, pazopanib, gemcitabine-docetaxel; afami-cel for MAGE-A4 synovial sarcoma.

See Soft tissue sarcoma trials recruiting now →