How do you approach treatment for solitary fibrous tumor with a multifocal pleural-based metastatic recurrence that is surgically inoperable in a patient with good performance status?

Standard sarcoma chemotherapy does NOT work unless SFT has dedifferentiated into a frank sarcoma. For SFT, VEGFR inhibition helps. Options tested are temozolomide/bevacizumab (Park, et al. Cancer 2011), sunitinib or pazopanib.

In addition to the options put forth by @Dr. First Last, there is a retrospective describing activity of trabectedin for SFT: Efficacy of trabectedin in malignant solitary fibrous tumors: a retrospective analysis from the French Sarcoma Group.

I have had some luck with trabectedin.

There is a case rep...