Advancing Precision Medicine in Uterine Leiomyosarcoma

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Uterine leiomyosarcoma (uLMS) is a rare, aggressive cancer in the uterus. It typically affects women between 45 and 60, often during perimenopause.

uLMS cases are usually discovered incidentally in women who undergo surgery to remove masses that are presumed to be benign uterine fibroids. Approximately one to five out of every 1,000 women with presumed fibroids are ultimately diagnosed with uLMS after the removed masses are tested. uLMS grows and metastasizes rapidly, carrying the worst prognosis among similar cancers called soft tissue sarcomas. Only one-quarter to three-quarters of patients survive for at least five years after their diagnosis, and as few as 10 percent of patients survive for at least five years if their disease has already metastasized when diagnosed.

The underlying causes of uLMS are highly complex and vary from case to case. They may involve irregularities in patients’ genomes, genome-regulating epigenetic attributes, metabolic pathways, or immune systems. This heterogeneity has made it challenging for researchers to narrow down a single target (or even a few targets) against which to develop therapies. Research is also hindered by the lack of robust model systems for uLMS, such as mouse models or cell cultures, which are typically used to help understand the disease or develop therapies.

uLMS treatment remains limited beyond surgical removal, which does not always eliminate all cancerous tissue. Conventional chemotherapy has shown only modest survival benefits in clinical trials. Radiation therapy is generally avoided due to the proximity of radiation-sensitive pelvic organs. Although other cancers have seen treatment progress thanks to targeted immunotherapies, there are currently no uLMS-specific therapies that have been approved by the US Food and Drug Administration.

Given the aggressive nature of uLMS, its poor prognosis, and the lack of effective treatments, there is an urgent need to understand the disease’s underlying biology and develop novel therapeutic approaches. The Science Philanthropy Accelerator for Research and Collaboration (SPARC) is conducting a comprehensive review of research and clinical practice in uLMS, which will result in a publicly available report that distributes knowledge about this rare, complex cancer and identifies targeted opportunities where philanthropic funding can make an outsized impact on improving the lives of uLMS patients and their loved ones.

 

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Nathan Jefferson

Senior Associate, Research
Nathan Jefferson is a senior associate on the research team at the Milken Institute. In this role, he contributes to the Institute’s research on regional economics and international finance.
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Avery Ching

Avery Ching is the chief executive officer, chief technology officer, and co-founder of Aptos Labs, the team that helped to launch the Aptos layer-1 blockchain.
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Dan Buettner

Dan Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and New York Times bestselling author. He discovered the five places in the world—dubbed Blue Zones hotspots—where people live the longest, healthiest lives.
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Gary A. Officer

Gary A. Officer is a seasoned C-suite executive with extensive leadership experience across the workforce development, affordable housing, consumer finance, and public policy sectors.

Pathways to Capital

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The Milken Institute’s Pathways to Capital portfolio includes our signature programs designed to support the deployment of capital to people, places, and projects. This portfolio focuses on lifting up small business owners, emerging talent, and critical community infrastructure projects through direct engagement, innovation, and public-private partnerships. Pathways to Capital offers technical assistance training, resources, and connectivity to catalytic capital and capacity to help communities build long-term economic resilience and support the next generation of local leadership.

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