Caffeine-potentiated chemotherapy for patients with high-grade soft tissue sarcoma: long-term clinical outcome

Caffeine, which has a DNA-repair inhibiting effect, enhances the cytocidal effects of anticancer drugs and radiation. The present study was performed to assess the efficacy of caffeine-potentiated chemotherapy for high-grade soft tissue sarcoma (STS).

A non-randomised prospective clinical trial was initiated for 90 patients with non-metastatic (stages II and III) or metastatic (stage IV) STS. Following doxorubicin or ifosfamide combined with caffeine, with or without radiotherapy, 88 patients were treated surgically. A radiographic and histological response to chemotherapy was assessed. Local-recurrence free, distant-metastasis free and overall survival were analyzed by multivariate analysis.

Radiographic and histological response rates were 57.8% and 42%, respectively. The local recurrence rate was 23.7% in stages II and III and 13.6% in stage IV. Lung metastases newly developed in 21 (35.6%) patients at stages II and III. With a median follow-up period of 52 months, the overall 5-year cumulative survival rate at stages II and III was 80.7%. Local recurrence-free survival for the histological responders and distant metastasis-free survival for the radiographic responders at stages II and III were significantly improved compared to the non-responders (p=0.004 and p=0.034). Overall survival for the radiographic responders at all stages was significant longer than for the non-responders (p=0.009).

Caffeine-potentiated chemotherapy resulted in a favourable radiographic response and prolonged overall survival of the patients at all stages.