Treatment at Relapse for Synovial Sarcoma of Children, Adolescents and Young Adults: From the State of Art to Future Clinical Perspectives.

While the overall prognosis is generally quite satisfactory in children, adolescents and young adults with localised synovial sarcoma at first diagnosis, the outcome remains poor for patients after relapse. Conversely to the front-line standardised treatment options, patients with relapse generally have an individualised approach and to date, there is still a lack of consensus regarding standard treatment approaches. Studies on relapsed synovial sarcoma were able to identify some prognostic variables that influence post-relapse survival, in order to plan risk-adapted salvage protocols. Treatment proposals must consider previous first-line treatments, potential toxicities, and the possibility of achieving an adequate local treatment by new surgery and/or re-irradiation. Effective second-line drug therapies are urgently needed. Notably, experimental treatments such as adoptive engineered TCR-T cell immunotherapy seem promising in adults and are currently under validation also in paediatric patients.
Competing Interests: Dr Pablo Berlanga received grants for Drug supply for a trial from BAYER; an advisor for EUSA Pharma, outside the submitted work. Dr Susanne Andrea Gatz reports sponsorship of clinical trial from AstraZeneca, grants from BAYER, advisory board participation and received consultant fees from EMD Serono/MERCK KGaA, consultant fees for being reviewer on joint French Cancer Institute/AMGEN call from AMGEN, sponsorship of clinical trial from GSK, outside the submitted work. Dr Daniel Orbach reports grants from Bayer Inc., outside the submitted work. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2023 Ferrari et al.)