D’Ambrosio L, Touati N, Blay JY, et al. - Since there is a debate around the optimal treatment for advanced leiomyosarcoma, so, researchers retrospectively assessed doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone as first-line therapies for advanced/metastatic leiomyosarcoma managed at European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC-STBSG) sites. Experts selected 303 eligible patients. In the 2:1:2 propensity score–matched group (205 patients), the median progression-free survival (PFS) for doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone was estimated to be 9.2 months, 8.2 months, and 4.8 months with overall response rates (ORRs) of 30.9%, 19.5%, and 25.6%, respectively. Doxorubicin plus dacarbazine vs doxorubicin was related to significantly longer PFS. Longer overall survival was observed in relation to doxorubicin plus dacarbazine vs both doxorubicin plus ifosfamide and doxorubicin. This work represents the largest retrospective analysis of first-line therapy for advanced leiomyosarcoma. Favorable activity in terms of both ORR and PFS was displayed by doxorubicin and dacarbazine in the propensity score–matched population.