Customized Soft Tissue Sarcoma Treatment Options Are One Call Away
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Early, Late-Stage, and Metastatic Soft Tissue Sarcoma Treatment
Options
Powerful Integrative Treatment Options to Help Soft Tissue
Sarcomas Respond to Care
Soft Tissue Sarcomas (STS) may be difficult to diagnose and treat due to their varied subtypes and rare occurrences,
but
our team of integrative physicians overcome these challenges with innovative diagnostics, proprietary treatment
options, and extensive clinical experience in treating rare and complicated cancers. At Envita Medical Centers, a
world-class integrative center for precision oncology, we go beyond the scope of standard radiotherapy, chemotherapy
regimens, and invasive surgeries, to treat different types of sarcomas, such as, angiosarcomas, synovial sarcomas, and
leiomyosarcomas.
In our clinical experience of over 25 years treating various types and stages of cancers, even advanced soft tissue
sarcomas, we have been able to help several patients who were left with hardly any treatment options in other cancer
centers.
Disclaimer: Individual results will vary. Envita makes no guarantees for outcomes. Each patient case is unique. Please
consult your doctor before making any changes to your medical treatment. Not every patient is a candidate for care or
achieves these results. Treatments used in this case may not all be FDA approved for the treatment of this condition.
Our personalized treatment of soft tissue sarcomas comprises a powerful blend of the latest in conventional and
research-based natural medicines, targeted to strike at the unique set of factors responsible for the growth and
spread
of this rare form of cancer. Envita’s proprietary treatments, such as, personalized immunotherapies, CIPI™, and GTFC™,
have proved beneficial in treating soft tissue sarcoma patients, including those experiencing recurrence after
standard
treatments, like Isabel.
This article covers the following facts about adult soft tissue sarcomas:
The Envita Advantage Over Standard Treatments and Clinical Trials
Standard treatment of Soft Tissue Sarcomas follows the NCCN (National Comprehensive Cancer Network) guidelines, which
dictate treatment based on sarcoma type, stage, and grade, which is often not enough to treat such rare cancers with
diverse histological subtypes. In fact, according to a medical study, these tumors are notorious for
recurring and metastasizing - often with devastating results - despite complete
resection [1].
Surgery is considered the first-line treatment for STS, but in many cases the tumor grows back in the same area as a
local recurrence with or without metastatic spread, yet it may also
manifest as metastatic disease in a different part of the body. To slow down metastases, we deactivate
the tumor while creating a systemic immunotherapy response via our precision CIPI™, one of our innovative minimally
invasive approaches to soft tissue tumor treatment.
According to the American Cancer Society’s report
based on patient outcomes across standard cancer centers, which follow
the NCCN guidelines, the 5-year relative survival
rate of Soft Tissue Sarcomas drop down to a dismal 15% when the
disease spreads to distant parts of the body, highlighting
the need for precision care.
At Envita, we utilize personalized precision oncology treatments for all our patients irrespective of whether they
have
a low-grade or high-grade STS of any type or stage, to reduce chances of a potential metastasis and work towards
progression-free survival. This approach is crucial especially when a multicenter study also indicates the need for additional
treatment options as metastatic STS patients have poor clinical outcomes, despite
achieving favorable response to chemotherapy [2].
The standard NCCN guideline treatments for STS are surgery, radiation therapy, neoadjuvant or adjuvant chemotherapy,
or
clinical trials, depending on the stage of STS and its extent of spread, such as, metastasis to nearby lymph nodes or
other distant parts of the body. However, these standard treatments may not always be enough for patients as
corroborated by a Lancet study, which indicates
adjuvant chemotherapy with certain standard medications in resected soft-tissue sarcoma showed no
benefit in relapse-free survival or overall survival [3].
Often patients need more than what is offered in standard of care, and that’s what Envita has been
specializing in for
well over two decades. We combine the benefits of advanced genetic targeting and immunotherapy with
precision minimally
invasive surgery to offer a comprehensive treatment plan, which is personalized to attack each patient’s
unique set of
cancer drivers, responsible for the growth and spread of cancer cells in their body.
Our approach is in stark contrast with large sample clinical trials, which focus on testing the efficacy of new drugs
or
treatments rather than personalizing treatments based on each patient’s individual cancer drivers.
Personalization is Key to Improving Overall Survival
At Envita, we follow the N-of-1 clinical trial
approach, which is a single-subject clinical trial with an individual patient as the sole unit of observation in a
study
investigating the efficacy or side-effects of different interventions [4]. This level of personalization enables our
expert team to modify treatment as and when needed to consistently attack the cancer cells from all possible angles,
while reactivating the patient’s immune system, which play a crucial role in improving overall survival.
Envita Medical Centers Medical Team
Physicians with MD, MD(h), and NMD medical
licenses, including certified oncologists, and certified interventional radiologists,
striving to provide the latest cancer innovations
22
Pharmacists specializing in integrative agents
7
Nurses trained in precision treatment delivery
40+
These cancers of the soft tissues can develop in any part of the body, but 40% of all STS occur in the extremities, leading to
amputation of the affected limb or other invasive surgeries, as a treatment option
[5]. Comparative medical studies also indicate
that treatment options, such as amputation, does not increase overall survival [6]. However, Envita’s
4-step process of building a unique medical blueprint for each of our patients is aimed at optimizing quality of life,
increasing longevity, and reducing toxicities, a common side-effect of cancer treatment.
Our personalized protocols are designed to deactivate tumors through various proprietary non- invasive and minimally
invasive options, while simultaneously building up the patient’s immune system to help keep potential recurrence and
metastasis at bay. In our clinical experience, this unique precision oncology approach provides a greater chance of
sustaining long-term remissions while progressing towards a holistic recovery.
Step 1
Genomic Identification is Crucial for a Comprehensive Cancer Care Plan
A detailed genomic identification forms a strong foundation for
building a comprehensive plan targeted towards attacking the diverse histological subtypes
of STS. According to a 2020 study titled "Precision
Medicine in Soft Tissue Sarcoma Treatment", for rare diseases, rare mutation-targeted therapies are pursued, and
the importance of detecting targeted mutations
precisely is greater [7]. However, not everyone gets access to detection of targeted mutations, because the NCCN
guidelines provide precision oncology care as a follow-up to failed first-line treatments.
At Envita, Precision Oncology is Crucial to Each Patient’s Comprehensive
First-line Treatment Plan!
Even when patients get access to precision oncology as second-line treatment, they receive a watered-down version of
Envita’s STS Precision Treatment Program. Our advanced precision algorithms take into account many more factors than
“chemosensitivity of histological subtype, natural history of the diagnosis, tumour burden, . . . and patient
acceptance,” parameters considered critical to care as part of a medical review on patient-tailored management of soft tissue
sarcomas [8].
Envita Precision Algorithm vs. Standard Oncology Precision Testing
Envita Medical Centers
Standard Oncology Precision Testing
RNA Transcriptome Genes
Envita Medical Centers:20,000+
Standard Oncology:Unchecked
SNV/CNV Genes
Envita Medical Centers:452
Standard Oncology:309
Rearrangements/Fusion Genes
Envita Medical Centers:51
Standard Oncology:27
Microsatellite Instability (MSI)
Envita Medical Centers:Checked
Standard Oncology:Checked
Tumor Mutation Burden (TMB)
Envita Medical Centers:Checked
Standard Oncology:Checked
BRCA 1/2
Envita Medical Centers:Checked
Standard Oncology:Checked
Immunohistochemistry
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Chemosensitivity
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Concurrent Liquid Biopsy
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Exosomal miRNA Analysis
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Circulating Tumor Cells Enumeration
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Pharmacogenomics
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Individualized Therapy Recommendation
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Carcinogenic Exposure - Root Causes
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Inflammation Markers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Metabolic Target Drivers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
However, we go beyond these parameters to identify the core causative factors of the diseases and treat them
holistically. Our in-depth research
study and clinical experience indicate how infections could also be a potential risk factor for causing certain
types of soft
tissue sarcomas, such as Leiomyosarcoma and Kaposi’s Sarcoma [9].
Step 2
Immuno Targeting Aims at Enhancing Response Rate
Our detailed precision oncology approach has helped us in developing various levels of innovative immunotherapies for STS patients of all stages, types, and
grades. A 2019 study reiterates how the
development of immunotherapy for sarcomas also benefits from a precision oncology approach both in
identifying predictive biomarkers and in developing strategies targeted to specific antigens [10]. Biomarkers refer to
the proteins, genes, and other molecules which influence your specific soft tissue sarcoma’s growth and proliferation.
Biomarkers can be detected by examining the Circulating Tumor Cells (CTCs), which break away from a growing
tumor and
enter the blood to spread the disease further. Envita’s Ultra Analytes liquid biopsy helps in keeping track of
the
latest mutations by investigating the CTCs, which is crucial for identifying early signs of metastasis and
enabling our
team to proactively treat the disease.
Our targeted immunotherapies go beyond smart drugs and tyrosine kinase inhibitors, which work by blocking
messaging to
corresponding cell receptors, preventing cancerous growth. We dive deep into cancer cell biology to comprehend
factors
like genomics, transcriptomics, proteomics, and metabolomics, which can influence disease proliferation. In an
effort to
bring the best treatments from around the world, our research and development team is constantly working on data
derived
from various studies to further improve control of
sarcoma [11].
Step 3
Personalized Drug Design Boosts the Efficacy of Systemic Therapies
Medical studies emphasize the need to
continue
the search for
more effective agents to treat advanced STS patients, and our personalized
drug design is aimed at effectively bridging that gap [12]. We are not limited by the STS treatment drugs
available on
the market, as we custom compound adjuvants at our in-house pharmacy to personalize
treatments
and enhance the efficacy of systemic therapies for all our soft tissue sarcoma patients.
FDA Approved Drugs
Optimized for your cancer mutations.
Repurposed Drugs
Off-label use of approved medications
Custom Compounded Adjuvants
Genetically typed for each patient.
Our personalized drug design includes a combination of FDA
(Food and Drug Administration) approved drugs, repurposed drugs, and custom compounded
adjuvants, aimed at providing the best chances of recovery.
Precision Deployment Reduces Side Effects for Better Results
Our precision deployment mechanisms are utilized to administer personalized precision medicines either intravenously
or
through minimally invasive interventional radiology procedures. They are designed to precision target the STS
cancerous
cells, without impacting the adjoining healthy cells, thus reducing treatment side effects which helps patients
experience targeted care. A 2020 study
reiterates how future advances in the field of molecular biology related to sarcomas hold great promise to overcome
treatment resistance and treatment-related toxicity through individualized precision medicine approaches, which is in
sync with what we are doing here at Envita [13].
Here are some of our treatments, which have proved beneficial for STS patients:
CIPI™ (Chemo Immuno Precision Injections)
CIPI™ (Chemo Immuno Precision Injections) is our proprietary interventional radiology procedure for tumor
chemoembolization. It has the advantage of accessing difficult to reach tumors, which is crucial in soft tissue
sarcoma
treatment, given the high chances of a precarious location of tumors, which could be on blood vessels, nerves, or deep
seated in any part of the body.
As part of the CIPI™ procedure, a tiny catheter,
thinner than a strand of hair, is used to carry chemo and immuno agents directly to the
tumor, and the antigen released during tumor die-off is utilized to train the patient’s immune system into identifying
the presence of cancer cells elsewhere in the body. This minimally invasive technology has several long-term benefits
over other standard treatment options.
Envita's CIPI™ vs. Standard Surgery
Envita Medical Centers
Standard Surgery
Minimally invasive so it can be performed within 40-50 minutes, without the need for large surgical
incisions.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Can be performed multiple times, even at close intervals, because there is minimal risk of post-op
complications.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
No need for general anesthesia, reducing the health risks that can result from being put into a
medically induced coma to perform an invasive surgery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Faster recovery time as compared to traditional surgery, due to the minimally invasive administration.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Provides direct tumor targeting, which delivers patient-specific genomic agents into the tumor.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Causes a systemic immune response where the immune system is reactivated to find and attack other
metastatic cancer sites in the body.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Performed by highly trained medical professionals in an outpatient setting, so there is no need of
hospital stays for recovery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
Pulsed Electric Field (PEF) Ablation
Ablations are also an interventional radiology procedure, and in PEF ablations, interventional radiologists use
needles
to deliver very quick pulses of energy to the tumor. This delivery creates an electric field that forms holes in cell
walls, damaging the cells beyond repair and leading to cell death. Contrary to other forms of ablation, like
cryoablation, microwave, or radiofrequency ablations, PEF does not rely on extreme temperatures to impact the
cancerous
cells, which makes them a favorable treatment option, especially for the difficult to reach sarcomas.
At Envita, our team of specially trained physicians also focus on enhancing tumor-specific immune response after PEF
ablation, which is aimed at improving the efficacy of this treatment. To potentiate outcomes, PEF ablation may be used
in combination with CIPI™ as well. Envita is one of the first places in Arizona to offer PEF ablations.
GTFC™ (Genetically Targeted Fractionated Chemotherapy) is our proprietary low-dose chemotherapy which is aimed at
optimizing treatment benefits by taking the guesswork out of your treatment. Unlike, standard maximum dose untargeted
chemotherapy, GTFC™ is based on advanced genomic analysis
which
guides us to the most effective chemo agents suitable for you. With this knowledge, we are better equipped to enhance
the mechanisms of action against your cancerous cells, while reducing impact to surrounding healthy cells, which paves
the way for your holistic recovery.
Envita's GTFC™ vs. Standard Chemotherapy
Envita Medical Centers
Standard Chemotherapy
Helps to improve chemotherapy delivery to the tumor using a "Trojan Horse" delivery mechanism.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses genetic molecular profiling to understand all the facets of each patient's specific cancer.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses targeted treatment to enhance the mechanism of cancer kill.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses microdosed (fractionated) chemotherapies, reducing the chances of impacting healthy cells.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Minimizes toxicity to normal cells, lowering the chance of side-effects related to administration.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses patient-specific supportive immunotherapy to strengthen the immune system.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Aims to reduce multidrug resistance by administering 10 - 20% of the medication delivered in maximum dose
chemo.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Allows custom-compounded medications to be readministered in tandem to suit each patient's individual cancer
mutations.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
Types of Soft Tissue Sarcomas (STS)
Soft Tissue Sarcomas (STS) and Osteosarcomas are the two different types of sarcomas, which are cancers of
mesenchymal
tissues, found in fat, muscles, blood vessels, nerves, cartilage, and bone. They can develop in any part of the body,
which explains why both the bone sarcoma group as well as the soft tissue sarcomas are further divided into various
histological subtypes. Some of the STS subtypes, generally manifesting in the arms, legs, trunk, retroperitoneum,
head,
neck, chest, and abdomen region are as follows:
Angiosarcoma: Begins in the blood vessels or lymph vessels and may be caused due to the side effect of
radiation therapy.
Liposarcoma: Malignant tumor of the fat tissues, which can start anywhere in the body. There are various
subtypes of Liposarcomas,
such as well differentiated, dedifferentiated, myxoid, round cell, and pleomorphic, which determines their rate
of
growth and aggressiveness.
Leiomyosarcoma: Cancer of the smooth muscle tissues.
Fibrosarcoma: Starts in the fibrous tissues of arms, legs, or trunks.
Clear Cell Sarcoma: Rare type of STS originating in the tendons of legs or arms.
Kaposi Sarcoma: Cancer originating in the cell lining of blood vessels or lymph vessels.
Synovial Sarcoma: Malignant tumor of the tissue around joints, such as, shoulder, hip, knee, and ankle.
Epithelioid Sarcoma: Generally, develops in tissues under the skin of feet, lower legs, hands, or
forearms.
Undifferentiated Pleomorphic sarcoma (UPS): Begins in the legs, arms, or retroperitoneal region, and is
known to proliferate adjoining tissues.
Perivascular Epithelioid Cell Tumor: Rare tumors which begin in the soft tissues of lungs, intestine,
stomach, or female reproductive organs.
Peripheral Nerve Sheath Tumors: Starts in the cells surrounding the nerves.
Alveolar soft-part sarcoma: Commonly starts in the leg region and is a rare cancer mostly affecting young
adults.
Gastrointestinal Stromal Tumors (GIST): A type of STS originating in the gastrointestinal tract.
Rhabdomyosarcoma: Begins in the cells that develop into voluntary muscles. This type of STS is commonly
seen in children, although it may
occasionally affect adults as well.
If you notice any of the following symptoms, your local healthcare provider may use X-ray, CT scan, MRI, PET scan, or
a
biopsy to determine whether you have STS:
Our expert medical team undergoes extensive training of over 1,500 hours to adapt to this personalized precision
oncology approach, which is crucial in treatment of cancers, especially rare and complicated diseases like soft tissue
sarcomas. We work relentlessly towards building a unique treatment plan for each induvial patient, designed to uproot
the disease from its core. If you or any of your loved ones have questions regarding STS or any other cancers, please
call us at 866-830-4576. We are looking forward to hearing from you. May God bless you on your journey to healing!
References
[1] Morrison BA. Soft tissue sarcomas of the extremities. Proc (Bayl Univ Med Cent). 2003;16(3):285-290.
doi:10.1080/08998280.2003.11927915
[2] Leahy M, Garcia Del Muro X, Reichardt P, et al. Chemotherapy treatment patterns and clinical outcomes in
patients with
metastatic soft tissue sarcoma. The SArcoma treatment and Burden of Illness in North America and Europe (SABINE)
study.
Ann Oncol. 2012;23(10):2763-2770. doi:10.1093/annonc/mds070
[3] Woll PJ, Reichardt P, Le Cesne A, et al. Adjuvant chemotherapy with [removed due to editorial restrictions],
[removed
due to editorial restrictions], and [removed due to editorial restrictions] for resected soft-tissue sarcoma (EORTC
62931): a multicentre randomised controlled trial. Lancet Oncol. 2012;13(10):1045-1054.
doi:10.1016/S1470-2045(12)70346-7
[4] Lillie EO, Patay B, Diamant J, Issell B, Topol EJ, Schork NJ. The n-of-1 clinical trial: the ultimate
strategy for
individualizing medicine?. Per Med. 2011;8(2):161-173. doi:10.2217/pme.11.7
[5] Vodanovich DA, M Choong PF. Soft-tissue Sarcomas. Indian J Orthop. 2018;52(1):35-44.
doi:10.4103/ortho.IJOrtho_220_17
[6] Alamanda VK, Crosby SN, Archer KR, Song Y, Schwartz HS, Holt GE. Amputation for extremity soft tissue sarcoma
does not
increase overall survival: a retrospective cohort study. Eur J Surg Oncol. 2012;38(12):1178-1183.
doi:10.1016/j.ejso.2012.08.024
[7] Nakano K, Takahashi S. Precision Medicine in Soft Tissue Sarcoma Treatment. Cancers (Basel). 2020;12(1):221.
Published
2020 Jan 16. doi:10.3390/cancers12010221
[8] Blay JY, Sleijfer S, Schöffski P, et al. International expert opinion on patient-tailored management of soft
tissue
sarcomas. Eur J Cancer. 2014;50(4):679-689. doi:10.1016/j.ejca.2013.11.011
[9] Smith, A. , Oertle, J. and Prato, D. (2014) Cancer and Infectious Causes. Open Journal of Medical
Microbiology, 4,
161-177. doi: 10.4236/ojmm.2014.43019.
[10] Carmagnani Pestana R, Groisberg R, Roszik J, Subbiah V. Precision Oncology in Sarcomas: Divide and Conquer.
JCO Precis
Oncol. 2019;3:PO.18.00247. Published 2019 Apr 25. doi:10.1200/PO.18.00247
[11] Demetri GD, Chawla SP, Ray-Coquard I, et al. Results of an international randomized phase III trial of the
mammalian
target of rapamycin inhibitor ridaforolimus versus placebo to control metastatic sarcomas in patients after benefit
from
prior chemotherapy. J Clin Oncol. 2013;31(19):2485-2492. doi:10.1200/JCO.2012.45.5766
[12] Karavasilis V, Seddon BM, Ashley S, Al-Muderis O, Fisher C, Judson I. Significant clinical benefit of
first-line
palliative chemotherapy in advanced soft-tissue sarcoma: retrospective analysis and identification of prognostic
factors
in 488 patients. Cancer. 2008;112(7):1585-1591. doi:10.1002/cncr.23332
[13] Grünewald TGP, Alonso M, Avnet S, κ.ά. Sarcoma treatment in the era of molecular medicine. EMBO Molecular
Medicine.
2020;12(11):e11131. doi:10.15252/emmm.201911131
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