Is there a preferred neoadjuvant chemotherapy regimen for a marginally-resectable, dedifferentiated, MDM2+ liposarcoma?

In our experience, neoadjuvant chemotherapy alone is unlikely to convert someone from marginally resectable to more resectable. These patients are better served with neoadjuvant radiation therapy with the addition of weekly doxorubicin/cisplatin being an additional consideration.

There is no evidence to support neoadjuvant chemotherapy for RP DDLPS outside of a clinical trial.

The STRASS trial suggests a role for pre-op radiation for this subtype of RP sarcomas, but not other histologies.

As always, cases like this should be discussed in multidisciplinary sarcoma tumor board...