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Standard and high dose chemotherapy for advanced soft tissue sarcomas
1U.T.M.D. Anderson Cancer Center, Houston, TX.
Summary
Treatment for metastatic soft tissue sarcoma shows limited progress. While Adriamycin and DTIC offer some benefit, newer agents like ifosfamide are mainly effective as salvage therapy. High-dose chemotherapy shows promise but requires further survival data.
Area of Science:
- Oncology
- Medical Research
Background:
- Localized soft tissue sarcomas have seen management improvements.
- Metastatic soft tissue sarcoma treatment remains challenging with limited progress.
Purpose of the Study:
- To review the efficacy of current and emerging chemotherapy regimens for metastatic soft tissue sarcoma.
- To evaluate the role of ifosfamide and high-dose chemotherapy in sarcoma treatment.
Main Methods:
- Review of chemotherapy regimens including Adriamycin, DTIC, ifosfamide, and mesna.
- Analysis of response rates, toxicities, and survival data from clinical studies.
- Exploration of high-dose chemotherapy with growth factor support and bone marrow transplantation.
Main Results:
- Adriamycin/DTIC regimens yield up to 50% response rates with a small cure fraction.
- Ifosfamide is effective as salvage therapy (25-30% response) but not as an upfront agent with Adriamycin due to toxicity.
- High-dose chemotherapy shows improved response rates but survival impact is pending.
Conclusions:
- Current chemotherapy offers modest benefits for metastatic soft tissue sarcoma.
- Ifosfamide serves as a valuable salvage option.
- Further research into novel agents and high-dose strategies is crucial for improving outcomes.