How would you treat a patient with concurrent diagnoses of symptomatic multiple myeloma and a newly diagnosed upper extremity undifferentiated pleomorphic sarcoma?  

Partly would depend on the prognostic details of the UPS - ?size, ?resectable. Sounds like the "symptomatic MM" needs urgent treatment and should take precedence. Considering pre-op XRT followed by a planned surgical excision at an opportune time could address both active problems.

I would approach the upper extremity UPS with the same principle as an extremity sarcoma- pre-op RT followed by surgery. However, it seems that the myeloma treatment takes precedence here- hence, a 6-8 week delay in treating the UPS may have to be tolerated. I would not combine IO with RT in this pa...