{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:18:27Z","timestamp":1787764707420,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"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":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Nonuterine leiomyosarcoma (NU\u2010LMS) is a rare and biologically distinct subtype of soft tissue sarcoma (STS) with clinical behavior differing from that of uterine leiomyosarcoma. In advanced or metastatic STS, immunotherapy has demonstrated only modest activity, and chemotherapy remains the cornerstone of treatment. However, there is a persistent unmet need for more effective and better\u2010tolerated options in this population. This multicenter, retrospective study included 150 patients with histologically confirmed metastatic NU\u2010LMS who received first\u2010line doxorubicin\u2013ifosfamide (AI) or gemcitabine\u2013docetaxel (GD) at 26 oncology centers in Turkey between 2010 and 2024. The primary endpoint was overall survival (OS). Survival was analyzed using Kaplan\u2013Meier estimates and Cox proportional hazards models. Of 150 patients, 79 received AI and 71 received GD. Median OS for the entire cohort was 21.0\u2009months. Median OS was 22.0\u2009months with AI and 19.1\u2009months with GD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.18), median progression\u2010free survival was 7.3 versus 6.1\u2009months (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.66), and overall response rate was 25.3% versus 29.6% (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.58), indicating no statistically significant differences in efficacy between the two regimens. Hematologic toxicities were less frequent with GD. AI and GD demonstrated comparable efficacy as first\u2010line regimens for advanced or metastatic NU\u2010LMS, with fewer hematologic toxicities observed for GD. Tumor location may have prognostic implications. These findings support individualized treatment selection and highlight the need for prospective studies in this rare and understudied sarcoma subtype, while the recent LMS\u201004 trial underscores the importance of future comparisons with doxorubicin\u2013trabectedin to further refine first\u2010line strategies in LMS.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70212","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:15:26Z","timestamp":1761664526000},"page":"1703-1712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of doxorubicin\u2013ifosfamide versus gemcitabine\u2013docetaxel as first\u2010line therapy in advanced nonuterine leiomyosarcoma: A multicenter real\u2010world 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