Desmoid tumors exhibit highly variable behavior, acting as a chronic disease in some patients while being manageable in others. This necessitates a personalized, long-term treatment strategy rather than a standard protocol, often requiring a diverse armamentarium of therapeutic options to be used over a patient's lifetime as needs change.
For the typically young and active desmoid tumor patient population, the convenience of a once-daily oral pill is a major advantage. This seemingly simple feature significantly improves compliance and adherence compared to twice-daily regimens, making it a key factor in real-world treatment feasibility and success, more so than the specific milligram dosage.
As more effective treatments for desmoid tumors become available, a critical unmet need is emerging: knowing when to stop therapy. Future research must focus on identifying signals, such as radiologic changes on MRI, to guide treatment duration. This will help clinicians avoid both the risk of early relapse from stopping too soon and the toxicity of unnecessary overtreatment.
While new systemic treatments for desmoid tumors can effectively control the disease and improve quality of life by managing symptoms, they introduce their own set of side effects. This creates a clinical challenge where the positive impact on the tumor must be carefully weighed against the negative impact of the treatment itself on the patient's daily life.