{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:29:32Z","timestamp":1786418972325,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frontline systemic treatment selection for advanced leiomyosarcoma (LMS) remains variable in routine practice. Gemcitabine\u2010based regimens are frequently used despite randomized evidence of non\u2010superiority compared with doxorubicin\u2010based regimens and greater complexity in treatment delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multi\u2010centre retrospective cohort study included advanced\/metastatic LMS patients treated with frontline doxorubicin\u2010 or gemcitabine\u2010based chemotherapy at four Canadian sarcoma centres (2010\u20132022). The primary endpoint was overall survival (OS). Secondary endpoints were time to second\u2010line treatment (T2T) and number of subsequent systemic treatment lines. Subgroup analyses were conducted by primary tumor site (uterine vs. non\u2010uterine LMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 217 patients, median OS was 17.1\u2009months (95% CI 14.8\u201321.1). OS did not differ between frontline doxorubicin\u2010 and gemcitabine\u2010based regimens (17.8 vs. 16.1\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16), nor did T2T (5.8 vs. 6.3\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.77). Non\u2010uterine primary site and surgery following frontline systemic treatment were independently associated with improved OS. Median OS was longer for non\u2010uterine versus uterine LMS (23 vs. 12.8\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large real\u2010world LMS cohort, outcomes were not influenced by frontline chemotherapy choice. These findings support prioritizing toxicity, quality of life, cost, and treatment delivery burden when selecting frontline therapy, particularly where doxorubicin\/trabectedin use is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72080","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:45:55Z","timestamp":1784090755000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Frontline Systemic Treatment Choice on Clinical Outcome in Advanced Leiomyosarcoma: A\n                    <scp>CanSaRCC<\/scp>\n                    Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Erica C. 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