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Uterine leiomyosarcoma (uLMS) has long been a dreaded diagnosis among gynecologic oncologists. The rare disease known for its high recurrence rates and limited response among current therapeutic options continues to plague patients and providers with poor outcomes.

In every cancer site, we continue to see the movement towards personalized treatment based on molecular targets and genetic mutation defects rather than the site itself, and uLMS is one of those diseases that we may be able to target through these pathways. In an albeit , investigators enrolled uLMS patents and gave them a combination of a PARP inhibitor (olaparib) and an alkylating agent (temozolomide). Both of these drugs have been used as single agents for other gynecologic cancers, so we are relatively familiar with them.

Molecular profiling was also done on these tumors in an attempt to identify markers for patients with improved response rates. A best overall response rate of 27% was reached in this study, which met its primary endpoint. The treatment was relatively well tolerated with expected dose reductions in a heavily pre-treated trial group. The better responses were seen in patients with RAD51B and PALB2 deletions and ATR mutation.

I feel this is an important step in the treatment of a difficult disease. A relatively well-tolerated treatment with improved response rates, especially in patients with a molecular target that we can identify. I look forward to larger studies, which I hope will have similar outcomes for our patients.

Christy Walters Haygood, MD, is a gynecologic oncology specialist at St. Dominic's Jackson Memorial Hospital in Jackson, Mississippi.

Read the study here and an interview about it here.