Could adding immunotherapy to Pre-Sarcoma treatment boost survival?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Primary or recurrent soft tissue sarcoma of the extremity or trunk with intermediate- to high-grade disease and tumor size \>=5 cm or deep-seated tumor, for which radiotherapy is recommended after multidisciplinary evaluation. * Age \>=15 years. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 3. * Histologically confirmed soft tissue sarcoma. * At least one evaluable lesion. * Able to tolerate radiotherapy, anlotinib, and penpulimab treatment. * Female participants of childbearing potential, or male participants with female partners of childbearing potential, must agree to use effective contraception during the treatment period and for 6 months after the last dose of study treatment. * Able to provide written informed consent. * Able and willing to comply with follow-up. Exclusion Criteria: * No gross tumor remaining after unplanned tumor resection performed at another hospital. * Contraindications to targeted therapy or immunotherapy due to comorbidities, including allergy, autoimmune disease, active bleeding, ulcer, intestinal perforation, intestinal obstruction, uncontrolled hypertension, New York Heart Association class III-IV cardiac dysfunction, or severe hepatic or renal dysfunction. * Dermatofibrosarcoma protuberans, desmoid fibromatosis, tenosynovial giant cell tumor, or other locally aggressive diseases. * Benign tumors. * Sarcoma subtypes for which chemotherapy is recommended as the preferred neoadjuvant treatment according to guidelines, such as embryonal rhabdomyosarcoma or Ewing sarcoma. * Lipoma-like liposarcoma or well-differentiated liposarcoma. * New malignant tumor within 5 years before enrollment, except cervical carcinoma in situ, early-stage basal cell carcinoma of the skin, or early-stage lung cancer. * Soft tissue sarcoma that can be cured by wide local excision alone. * Prior radiotherapy to the same anatomical site. * Other severe medical comorbidities that would preclude surgery or participation in this study.