Leiomyosarcoma Therapeutic Approaches and Future Directions

Candace L Haddox; David J Papke Jr; César Serrano

doi:10.1016/j.hoc.2025.04.007

Leiomyosarcoma Therapeutic Approaches and Future Directions

Hematol Oncol Clin North Am. 2025 Aug;39(4):785-804. doi: 10.1016/j.hoc.2025.04.007. Epub 2025 May 22.

Authors

Candace L Haddox¹, David J Papke Jr², César Serrano³

Affiliations

¹ Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA. Electronic address: candace_haddox@dfci.harvard.edu.
² Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Department of Pathology, Harvard Medical School.
³ Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Sarcoma Translational Research Group, Natzaret, 115-11708035 Barcelona, Spain.

PMID: 40410055
DOI: 10.1016/j.hoc.2025.04.007

Abstract

Leiomyosarcomas (LMS) are mesenchymal malignancies with smooth muscle differentiation that most commonly arise in the uterus, retroperitoneum, and extremity. Clinical course is variable, and management differs by site of origin. Recently completed and ongoing clinical trials are optimizing LMS management, and multidisciplinary care by an expert team is essential to navigate the nuances and provide optimal care. Advances in molecular characterization have improved diagnosis and identification of novel prognostic factors and systemic therapies. This article provides an overview of LMS presentation, diagnosis, molecular features, and clinical management, and highlights advancements in LMS biology and treatment.

Keywords: Leiomyosarcoma; Metastasis-directed therapy; Molecular profiling; Systemic therapy.

Publication types

Review

MeSH terms

Disease Management
Female
Humans
Leiomyosarcoma* / diagnosis
Leiomyosarcoma* / etiology
Leiomyosarcoma* / therapy
Prognosis