What systemic therapy would you recommend for metastatic pleomorphic dermal sarcoma with a large inoperable solitary lung metastasis that is too large for radiotherapy?

This a rare entity, typically originating in the scalp/head and neck location, more locally aggressive than an AFX (atypical fibroxanthoma), but generally not as bad as a UPS. Very rarely, it can behave like a UPS with distant metastatic disease. NOTCH 1/2, FAT 1 mutations, and various CNAs have bee...

We are not given any patient background. Dermal sarcoma is a tricky diagnosis. They exist, but aggressive and poorly differentiated cutaneous squamous carcinomas can lose expression of cytokeratins and look like sarcoma.

Ha Lan et al., PMID 25263756

If the pathologist is walking through an IHC algorit...