{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:17:03Z","timestamp":1788171423825,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Metastatic leiomyosarcoma (LMS) is characterized by limited treatment options beyond first-line therapy, and cross-resistance among cytotoxic agents is often assumed to exist. However, differential sensitivity to distinct chemotherapy mechanisms may exist. We report the case of an 81-year-old woman diagnosed with metastatic LMS of unknown primary origin presenting with extensive hepatic and pulmonary involvement. Following eight cycles of first-line gemcitabine plus docetaxel, the patient achieved stable disease without objective tumor shrinkage. Given this limited response, a significant radiological response to subsequent therapy was not anticipated. Second-line oral capecitabine and temozolomide (CAPTEM) was initiated, resulting in a marked radiologic regression at four months, with reductions in hepatic metastases and pulmonary nodules and no new lesions. Treatment was well tolerated, with no grade 3\u20134 toxicities. This case demonstrates a differential response to gemcitabine-based therapy and sensitivity to alkylating agents in LMS, supporting a more individualized, mechanism-driven treatment sequencing approach.<\/jats:p>","DOI":"10.3390\/jcm15176668","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:21:19Z","timestamp":1788168079000},"page":"6668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiological Response to Capecitabine and Temozolomide in an Elderly Patient with Metastatic Leiomyosarcoma: A Case Report"],"prefix":"10.3390","volume":"15","author":[{"given":"Suayib","family":"Yalcin","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Hacettepe University, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-1649","authenticated-orcid":false,"given":"Can","family":"Kilinc","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hacettepe University, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3590-0426","authenticated-orcid":false,"given":"Taha Koray","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hacettepe University, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Dizdar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hacettepe University, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.32074\/1591-951X-213","article-title":"The 2020 WHO Classification of Soft Tissue Tumours: News and perspectives","volume":"113","author":"Sbaraglia","year":"2021","journal-title":"Pathologica"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Denu, R.A., Dann, A.M., Keung, E.Z., Nakazawa, M.S., and Nassif Haddad, E.F. 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