Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Current Concepts in Non-Gastrointestinal Stromal Tumor Soft Tissue Sarcomas: A Primer for Radiologists

  • Baheti, Akshay D. (Department of Radiology, Tata Memorial Centre) ;
  • Jagannathan, Jyothi P. (Department of Radiology, Brigham and Women's Hospital) ;
  • O'Neill, Ailbhe (Department of Radiology, Brigham and Women's Hospital) ;
  • Tirumani, Harika (Department of Radiology, University of Arkansas for Medical Sciences) ;
  • Tirumani, Sree Harsha (Department of Radiology, Brigham and Women's Hospital)
  • Received : 2016.08.09
  • Accepted : 2016.09.07
  • Published : 2017.01.01
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Abstract

Non-gastrointestinal stromal tumor (GIST) soft tissue sarcomas (STSs) are a heterogeneous group of neoplasms whose classification and management continues to evolve with better understanding of their biologic behavior. The 2013 World Health Organization (WHO) has revised their classification based on new immunohistochemical and cytogenetic data. In this article, we will provide a brief overview of the revised WHO classification of soft tissue tumors, discuss in detail the radiology and management of the two most common adult non-GIST STS, namely liposarcoma and leiomyosarcoma, and review some of the emerging histology-driven targeted therapies in non-GIST STS, focusing on the role of the radiologist.

Keywords

References

  1. Baheti AD, O'Malley RB, Kim S, Keraliya AR, Tirumani SH, Ramaiya NH, et al. Soft-tissue sarcomas: an update for radiologists based on the revised 2013 World Health Organization classification. AJR Am J Roentgenol 2016;206:924-932 https://doi.org/10.2214/AJR.15.15498
  2. Ducimetiere F, Lurkin A, Ranchere-Vince D, Decouvelaere AV, Peoc'h M, Istier L, et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One 2011;6:e20294 https://doi.org/10.1371/journal.pone.0020294
  3. Tirumani SH, Jagannathan JP, Krajewski KM, Shinagare AB, Jacene H, Ramaiya NH. Imatinib and beyond in gastrointestinal stromal tumors: a radiologist's perspective. AJR Am J Roentgenol 2013;201:801-810 https://doi.org/10.2214/AJR.12.10003
  4. Tirumani SH, Jagannathan JP, O'Regan K, Kim KW, Shinagare AB, Krajewski KM, et al. Molecular targeted therapies in non-GIST soft tissue sarcomas: what the radiologist needs to know. Cancer Imaging 2013;13:197-211 https://doi.org/10.1102/1470-7330.2013.0022
  5. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. World Health Organization classification of tumours of soft tissue and bone: pathology and genetics of tumours of soft tissue and bone, 4th ed. Lyon: IARC Press, 2013
  6. Fletcher CD. The evolving classification of soft tissue tumours -an update based on the new 2013 WHO classification. Histopathology 2014;64:2-11 https://doi.org/10.1111/his.12267
  7. Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology 2014;46:95-104 https://doi.org/10.1097/PAT.0000000000000050
  8. Helman LJ, Maki RG. Sarcomas of soft tissue, 5th ed. Philadelphia: Elsevier, 2014
  9. Quesada J, Amato R. The molecular biology of soft-tissue sarcomas and current trends in therapy. Sarcoma 2012;2012:849456
  10. Matushansky I, Maki RG. Mechanisms of sarcomagenesis. Hematol Oncol Clin North Am 2005;19:427-449, v https://doi.org/10.1016/j.hoc.2005.03.006
  11. Norberg SM, Movva S. Role of genetic and molecular profiling in sarcomas. Curr Treat Options Oncol 2015;16:24 https://doi.org/10.1007/s11864-015-0339-3
  12. Baheti AD, Tirumani SH, Sewatkar R, Shinagare AB, Hornick JL, Ramaiya NH, et al. Imaging features of primary and metastatic extremity synovial sarcoma: a single institute experience of 78 patients. Br J Radiol 2015;88:20140608 https://doi.org/10.1259/bjr.20140608
  13. Murphey MD, Senchak LT, Mambalam PK, Logie CI, Klassen-Fischer MK, Kransdorf MJ. From the radiologic pathology archives: ewing sarcoma family of tumors: radiologic-pathologic correlation. Radiographics 2013;33:803-831 https://doi.org/10.1148/rg.333135005
  14. Somarouthu BS, Shinagare AB, Rosenthal MH, Tirumani H, Hornick JL, Ramaiya NH, et al. Multimodality imaging features, metastatic pattern and clinical outcome in adult extraskeletal Ewing sarcoma: experience in 26 patients. Br J Radiol 2014;87:20140123 https://doi.org/10.1259/bjr.20140123
  15. Helman LJ, Maki RG. Sarcomas of soft tissue. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia: Elsevier, 2014:1753-1791
  16. Nishino M, Jagannathan JP, Krajewski KM, O'Regan K, Hatabu H, Shapiro G, et al. Personalized tumor response assessment in the era of molecular medicine: cancer-specific and therapy-specific response criteria to complement pitfalls of RECIST. AJR Am J Roentgenol 2012;198:737-745 https://doi.org/10.2214/AJR.11.7483
  17. What are the key statistics about soft tissue sarcomas? Web site. http://www.cancer.org/cancer/sarcoma-adultsofttissuecancer/detailedguide/sarcoma-adult-soft-tissue-cancer-key-statistics. Accessed Mar 29, 2016
  18. Murphey MD, Arcara LK, Fanburg-Smith J. From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 2005;25:1371-1395 https://doi.org/10.1148/rg.255055106
  19. O'Regan KN, Jagannathan J, Krajewski K, Zukotynski K, Souza F, Wagner AJ, et al. Imaging of liposarcoma: classification, patterns of tumor recurrence, and response to treatment. AJR Am J Roentgenol 2011;197:W37-W43 https://doi.org/10.2214/AJR.10.5824
  20. Wortman JR, Tirumani SH, Jagannathan JP, Tirumani H, Shinagare AB, Hornick JL, et al. Primary extremity liposarcoma: MRI features, histopathology, and clinical outcomes. J Comput Assist Tomogr 2016;40:791-798 https://doi.org/10.1097/RCT.0000000000000431
  21. Tirumani SH, Wagner AJ, Tirumani H, Shinagare AB, Jagannathan JP, Hornick JL, et al. Is the nonlipomatous component of dedifferentiated liposarcoma always soft tissue on CT? Analysis of CT densities and correlation with rate of growth in 60 patients. Abdom Imaging 2015;40:1248-1254 https://doi.org/10.1007/s00261-014-0267-x
  22. Brisson M, Kashima T, Delaney D, Tirabosco R, Clarke A, Cro S, et al. MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification. Skeletal Radiol 2013;42:635-647 https://doi.org/10.1007/s00256-012-1517-z
  23. O'Donnell PW, Griffin AM, Eward WC, Sternheim A, White LM, Wunder JS, et al. Can experienced observers differentiate between lipoma and well-differentiated liposarcoma using only MRI? Sarcoma 2013;2013:982784
  24. Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 2002;224:99-104 https://doi.org/10.1148/radiol.2241011113
  25. Baheti AD, Tirumani SH, Rosenthal MH, Howard SA, Shinagare AB, Ramaiya NH, et al. Myxoid soft-tissue neoplasms: comprehensive update of the taxonomy and MRI features. AJR Am J Roentgenol 2015;204:374-385 https://doi.org/10.2214/AJR.14.12888
  26. Lowenthal D, Zeile M, Niederhagen M, Fehlberg S, Schnapauff D, Pink D, et al. Differentiation of myxoid liposarcoma by magnetic resonance imaging: a histopathologic correlation. Acta Radiol 2014;55:952-960 https://doi.org/10.1177/0284185113508114
  27. van Vliet M, Kliffen M, Krestin GP, van Dijke CF. Soft tissue sarcomas at a glance: clinical, histological, and MR imaging features of malignant extremity soft tissue tumors. Eur Radiol 2009;19:1499-1511 https://doi.org/10.1007/s00330-008-1292-3
  28. Seo SW, Kwon JW, Jang SW, Jang SP, Park YS. Feasibility of whole-body MRI for detecting metastatic myxoid liposarcoma: a case series. Orthopedics 2011;34:e748-e754
  29. Keung EZ, Hornick JL, Bertagnolli MM, Baldini EH, Raut CP. Predictors of outcomes in patients with primary retroperitoneal dedifferentiated liposarcoma undergoing surgery. J Am Coll Surg 2014;218:206-217 https://doi.org/10.1016/j.jamcollsurg.2013.10.009
  30. Wortman JR, Tirumani SH, Tirumani H, Shinagare AB, Jagannathan JP, Hornick JL, et al. Neoadjuvant radiation in primary extremity liposarcoma: correlation of MRI features with histopathology. Eur Radiol 2016;26:1226-1234 https://doi.org/10.1007/s00330-015-3953-3
  31. Di Giandomenico S, Frapolli R, Bello E, Uboldi S, Licandro SA, Marchini S, et al. Mode of action of trabectedin in myxoid liposarcomas. Oncogene 2014;33:5201-5210 https://doi.org/10.1038/onc.2013.462
  32. Demetri GD, von Mehren M, Jones RL, Hensley ML, Schuetze SM, Staddon A, et al. Efficacy and safety of trabectedin or dacarbazine for metastatic liposarcoma or leiomyosarcoma after failure of conventional chemotherapy: results of a phase III randomized multicenter clinical trial. J Clin Oncol 2016;34:786-793 https://doi.org/10.1200/JCO.2015.62.4734
  33. Saponara M, Stacchiotti S, Gronchi A. The safety and efficacy of trabectedin for the treatment of liposarcoma or leiomyosarcoma. Expert Rev Anticancer Ther 2016;16:473-484 https://doi.org/10.1080/14737140.2016.1174582
  34. Tirumani SH, Wagner AJ, Tirumani H, Shinagare AB, Jagannathan JP, Morgan JA, et al. Radiologic signs of adipocytic maturation (AM) in dedifferentiated liposarcoma (ddLPS) patients treated with trabectedin (T): correlation with disease control [abstract]. J Clin Oncol 2014;32(15 Suppl). Abstract no.10561
  35. Wang WL, Katz D, Araujo DM, Ravi V, Ludwig JA, Trent JC, et al. Extensive adipocytic maturation can be seen in myxoid liposarcomas treated with neoadjuvant doxorubicin and ifosfamide and pre-operative radiation therapy. Clin Sarcoma Res 2012;2:25 https://doi.org/10.1186/2045-3329-2-25
  36. Engstrom K, Bergh P, Cederlund CG, Hultborn R, Willen H, Aman P, et al. Irradiation of myxoid/round cell liposarcoma induces volume reduction and lipoma-like morphology. Acta Oncol 2007;46:838-845 https://doi.org/10.1080/02841860601080415
  37. Dickson MA, Tap WD, Keohan ML, D'Angelo SP, Gounder MM, Antonescu CR, et al. Phase II trial of the CDK4 inhibitor PD0332991 in patients with advanced CDK4-amplified well-differentiated or dedifferentiated liposarcoma. J Clin Oncol 2013;31:2024-2028 https://doi.org/10.1200/JCO.2012.46.5476
  38. Ray-Coquard I, Blay JY, Italiano A, Le Cesne A, Penel N, Zhi J, et al. Effect of the MDM2 antagonist RG7112 on the P53 pathway in patients with MDM2-amplified, well-differentiated or dedifferentiated liposarcoma: an exploratory proof-of-mechanism study. Lancet Oncol 2012;13:1133-1140 https://doi.org/10.1016/S1470-2045(12)70474-6
  39. O'Sullivan PJ, Harris AC, Munk PL. Radiological imaging features of non-uterine leiomyosarcoma. Br J Radiol 2008;81:73-81 https://doi.org/10.1259/bjr/18595145
  40. Rosenberg AE. WHO classification of soft tissue and bone, fourth edition: summary and commentary. Curr Opin Oncol 2013;25:571-573 https://doi.org/10.1097/01.cco.0000432522.16734.2d
  41. Gordon RW, Tirumani SH, Kurra V, Shinagare AB, Jagannathan JP, Hornick JL, et al. MRI, MDCT features, and clinical outcome of extremity leiomyosarcomas: experience in 47 patients. Skeletal Radiol 2014;43:615-622 https://doi.org/10.1007/s00256-014-1823-8
  42. Tirumani SH, Ojili V, Shanbhogue AK, Fasih N, Ryan JG, Reinhold C. Current concepts in the imaging of uterine sarcoma. Abdom Imaging 2013;38:397-411 https://doi.org/10.1007/s00261-012-9919-x
  43. Shah SH, Jagannathan JP, Krajewski K, O'Regan KN, George S, Ramaiya NH. Uterine sarcomas: then and now. AJR Am J Roentgenol 2012;199:213-223 https://doi.org/10.2214/AJR.11.7287
  44. D'Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010;116:131-139 https://doi.org/10.1016/j.ygyno.2009.09.023
  45. Tanaka YO, Nishida M, Tsunoda H, Okamoto Y, Yoshikawa H. Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging 2004;20:998-1007 https://doi.org/10.1002/jmri.20207
  46. Schwartz LB, Zawin M, Carcangiu ML, Lange R, McCarthy S. Does pelvic magnetic resonance imaging differentiate among the histologic subtypes of uterine leiomyomata? Fertil Steril 1998;70:580-587 https://doi.org/10.1016/S0015-0282(98)00193-9
  47. Goto A, Takeuchi S, Sugimura K, Maruo T. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer 2002;12:354-361 https://doi.org/10.1046/j.1525-1438.2002.01086.x
  48. Sato K, Yuasa N, Fujita M, Fukushima Y. Clinical application of diffusion-weighted imaging for preoperative differentiation between uterine leiomyoma and leiomyosarcoma. Am J Obstet Gynecol 2014;210:368.e1-e8 https://doi.org/10.1016/j.ajog.2013.12.028
  49. Amant F, Coosemans A, Debiec-Rychter M, Timmerman D, Vergote I. Clinical management of uterine sarcomas. Lancet Oncol 2009;10:1188-1198 https://doi.org/10.1016/S1470-2045(09)70226-8
  50. Guntupalli SR, Ramirez PT, Anderson ML, Milam MR, Bodurka DC, Malpica A. Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis. Gynecol Oncol 2009;113:324-326 https://doi.org/10.1016/j.ygyno.2009.02.020
  51. Cooley CL, Jagannathan JP, Kurra V, Tirumani SH, Saboo SS, Ramaiya NH, et al. Imaging features and metastatic pattern of non-IVC retroperitoneal leiomyosarcomas: are they different from IVC leiomyosarcomas? J Comput Assist Tomogr 2014;38:687-692 https://doi.org/10.1097/RCT.0000000000000097
  52. Rajiah P, Sinha R, Cuevas C, Dubinsky TJ, Bush WH Jr, Kolokythas O. Imaging of uncommon retroperitoneal masses. Radiographics 2011;31:949-976 https://doi.org/10.1148/rg.314095132
  53. Webb EM, Wang ZJ, Westphalen AC, Nakakura EK, Coakley FV, Yeh BM. Can CT features differentiate between inferior vena cava leiomyosarcomas and primary retroperitoneal masses? AJR Am J Roentgenol 2013;200:205-209 https://doi.org/10.2214/AJR.11.7476
  54. Tirumani SH, Deaver P, Shinagare AB, Tirumani H, Hornick JL, George S, et al. Metastatic pattern of uterine leiomyosarcoma: retrospective analysis of the predictors and outcome in 113 patients. J Gynecol Oncol 2014;25:306-312 https://doi.org/10.3802/jgo.2014.25.4.306
  55. D'Incalci M, Galmarini CM. A review of trabectedin (ET-743): a unique mechanism of action. Mol Cancer Ther 2010;9:2157-2163 https://doi.org/10.1158/1535-7163.MCT-10-0263
  56. van der Graaf WT, Blay JY, Chawla SP, Kim DW, Bui-Nguyen B, Casali PG, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 2012;379:1879-1886 https://doi.org/10.1016/S0140-6736(12)60651-5
  57. Rajendra R, Jones RL, Pollack SM. Targeted treatment for advanced soft tissue sarcoma: profile of pazopanib. Onco Targets Ther 2013;6:217-222
  58. Penel N, Le Cesne A, Bui BN, Perol D, Brain EG, Ray-Coquard I, et al. Imatinib for progressive and recurrent aggressive fibromatosis (desmoid tumors): an FNCLCC/French Sarcoma Group phase II trial with a long-term follow-up. Ann Oncol 2011;22:452-457 https://doi.org/10.1093/annonc/mdq341
  59. Chugh R, Wathen JK, Patel SR, Maki RG, Meyers PA, Schuetze SM, et al. Efficacy of imatinib in aggressive fibromatosis: Results of a phase II multicenter Sarcoma Alliance for Research through Collaboration (SARC) trial. Clin Cancer Res 2010;16:4884-4891 https://doi.org/10.1158/1078-0432.CCR-10-1177
  60. Torreggiani WC, Al-Ismail K, Munk PL, Nicolaou S, O'Connell JX, Knowling MA. Dermatofibrosarcoma protuberans: MR imaging features. AJR Am J Roentgenol 2002;178:989-993 https://doi.org/10.2214/ajr.178.4.1780989
  61. Kim GK. Status report on the management of dermatofibrosarcoma protuberans: is there a viable role for the use of imatinib mesylate? In which cases may it be therapeutically helpful and in which cases not? J Clin Aesthet Dermatol 2011;4:17-26
  62. Rutkowski P, Debiec-Rychter M, Nowecki Z, Michej W, Symonides M, Ptaszynski K, et al. Treatment of advanced dermatofibrosarcoma protuberans with imatinib mesylate with or without surgical resection. J Eur Acad Dermatol Venereol 2011;25:264-270 https://doi.org/10.1111/j.1468-3083.2010.03774.x
  63. Labropoulos SV, Razis ED. Imatinib in the treatment of dermatofibrosarcoma protuberans. Biologics 2007;1:347-353
  64. Demetri GD, Antonia S, Benjamin RS, Bui MM, Casper ES, Conrad EU 3rd, et al. Soft tissue sarcoma. J Natl Compr Canc Netw 2010;8:630-674 https://doi.org/10.6004/jnccn.2010.0049
  65. Imakiire N, Fujino T, Morii T, Honya K, Mochizuki K, Satomi K, et al. Malignant pigmented villonodular synovitis in the knee -report of a case with rapid clinical progression. Open Orthop J 2011;5:13-16
  66. Snoots WM, Watkins D, Dockery D, Mennel R, Cheek BS. Pigmented villonodular synovitis responsive to imatinib therapy. Proc (Bayl Univ Med Cent) 2011;24:134-138 https://doi.org/10.1080/08998280.2011.11928700
  67. Cassier PA, Gelderblom H, Stacchiotti S, Thomas D, Maki RG, Kroep JR, et al. Efficacy of imatinib mesylate for the treatment of locally advanced and/or metastatic tenosynovial giant cell tumor/pigmented villonodular synovitis. Cancer 2012;118:1649-1655 https://doi.org/10.1002/cncr.26409
  68. Temple HT. Pigmented villonodular synovitis therapy with MSCF-1 inhibitors. Curr Opin Oncol 2012;24:404-408 https://doi.org/10.1097/CCO.0b013e328354c16b
  69. Mayer IA, Arteaga CL. The PI3K/AKT pathway as a target for cancer treatment. Annu Rev Med 2016;67:11-28 https://doi.org/10.1146/annurev-med-062913-051343
  70. Huang Z, Wu Y, Zhou X, Qian J, Zhu W, Shu Y, et al. Clinical efficacy of mTOR inhibitors in solid tumors: a systematic review. Future Oncol 2015;11:1687-1699 https://doi.org/10.2217/fon.15.70
  71. Tirumani SH, Shinagare AB, Hargreaves J, Jagannathan JP, Hornick JL, Wagner AJ, et al. Imaging features of primary and metastatic malignant perivascular epithelioid cell tumors. AJR Am J Roentgenol 2014;202:252-258 https://doi.org/10.2214/AJR.13.10909
  72. Dickson MA, Schwartz GK, Antonescu CR, Kwiatkowski DJ, Malinowska IA. Extrarenal perivascular epithelioid cell tumors (PEComas) respond to mTOR inhibition: clinical and molecular correlates. Int J Cancer 2013;132:1711-1717 https://doi.org/10.1002/ijc.27800
  73. Wagner AJ, Malinowska-Kolodziej I, Morgan JA, Qin W, Fletcher CD, Vena N, et al. Clinical activity of mTOR inhibition with sirolimus in malignant perivascular epithelioid cell tumors: targeting the pathogenic activation of mTORC1 in tumors. J Clin Oncol 2010;28:835-840 https://doi.org/10.1200/JCO.2009.25.2981
  74. Lovly CM, Heuckmann JM, de Stanchina E, Chen H, Thomas RK, Liang C, et al. Insights into ALK-driven cancers revealed through development of novel ALK tyrosine kinase inhibitors. Cancer Res 2011;71:4920-4931 https://doi.org/10.1158/0008-5472.CAN-10-3879
  75. Narla LD, Newman B, Spottswood SS, Narla S, Kolli R. Inflammatory pseudotumor. Radiographics 2003;23:719-729 https://doi.org/10.1148/rg.233025073
  76. Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO. Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 2012;198:W217-W227 https://doi.org/10.2214/AJR.11.7288
  77. Butrynski JE, D'Adamo DR, Hornick JL, Dal Cin P, Antonescu CR, Jhanwar SC, et al. Crizotinib in ALK-rearranged inflammatory myofibroblastic tumor. N Engl J Med 2010;363:1727-1733 https://doi.org/10.1056/NEJMoa1007056
  78. Lovly CM, Gupta A, Lipson D, Otto G, Brennan T, Chung CT, et al. Inflammatory myofibroblastic tumors harbor multiple potentially actionable kinase fusions. Cancer Discov 2014;4:889-895 https://doi.org/10.1158/2159-8290.CD-14-0377
  79. de Bono JS, Yap TA. Future directions in the evaluation of c-MET-driven malignancies. Ther Adv Med Oncol 2011;3(1 Suppl):S51-S60 https://doi.org/10.1177/1758834011423540
  80. Giubellino A, Linehan WM, Bottaro DP. Targeting the Met signaling pathway in renal cancer. Expert Rev Anticancer Ther 2009;9:785-793 https://doi.org/10.1586/era.09.43
  81. Sood S, Baheti AD, Shinagare AB, Jagannathan JP, Hornick JL, Ramaiya NH, et al. Imaging features of primary and metastatic alveolar soft part sarcoma: single institute experience in 25 patients. Br J Radiol 2014;87:20130719 https://doi.org/10.1259/bjr.20130719
  82. Davis IJ, McFadden AW, Zhang Y, Coxon A, Burgess TL, Wagner AJ, et al. Identification of the receptor tyrosine kinase c-Met and its ligand, hepatocyte growth factor, as therapeutic targets in clear cell sarcoma. Cancer Res 2010;70:639-645 https://doi.org/10.1158/0008-5472.CAN-09-1121
  83. Wagner AJ, Goldberg JM, Dubois SG, Choy E, Rosen L, Pappo A, et al. Tivantinib (ARQ 197), a selective inhibitor of MET, in patients with microphthalmia transcription factor-associated tumors: results of a multicenter phase 2 trial. Cancer 2012;118:5894-5902 https://doi.org/10.1002/cncr.27582

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