There have been few novel presurgical treatment options in soft tissue sarcoma (STS) of the extremity during the past several years that have consistently yielded better recurrence rates than those found with negative surgical margins alone.1 For example, although olaratumab, a targeted therapy, became the first first-line STS therapy to be approved in decades, the treatment was later removed from the market after it failed to demonstrate an overall survival (OS) benefit in a phase 3 trial.2,3

Preoperative and postoperative radiotherapy are standard treatment options for patients with STS of the extremity; these methods are, however, associated with surgery-related wounds and more long-term morbidities, respectively.4,5

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Given the high local recurrence rate in STS, new treatments are badly needed to help improve long-term response rates in patients who undergo limb-sparing surgery. The advent of radiation-enhancing nanoparticles is promising for patients undergoing radiotherapy in all solid cancers, but it is especially promising in patients with STS, given the near-ubiquity of preoperative  or postoperative radiotherapy in this population.

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For the randomized Act.In.Sarc trial, the interim results of which were published in The Lancet Oncology, researchers evaluated the safety and efficacy of NBTXR3 — a first-in-class nanoparticle made up of crystalline hafnium oxide — in patients with locally advanced STS.6

“Because of NBTXR3’s chemical makeup, these particles act differently than other nanoparticles — and can contribute better to direct cell killing, without affecting normal tissue to a great degree,” Juliette Thariat, of the Institut Universitaire de la Face et du Cou in Nice, France, told Cancer Therapy Advisor.