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Updated: Jul 9, 2026
Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
Published on: April 11, 2018
The pharmacologic basis of ifosfamide use in adult patients with advanced soft tissue sarcomas
Metin Tascilar1, Walter J Loos, Caroline Seynaeve
1Department of Medical Oncology, Erasmus University Medical Center Rotterdam-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075EA Rotterdam, The Netherlands.
Abstract:
The treatment outcome of patients with locally advanced and metastatic soft tissue sarcomas is poor. Doxorubicin is regarded as standard treatment, but its use is featured by the occurrence of cardiotoxicity. This hinders the administration of this drug at high doses or in combination with, in theory, attractive newly developed targeted drugs, such as vascular endothelial growth factor (VEGF) pathway inhibitors. The combination of doxorubicin and VEGF pathway inhibitors has been shown to yield an unacceptable high rate of cardiomyopathy. Ifosfamide is the only drug that consistently shows response rates comparable to those of doxorubicin. The lack of cardiotoxicity renders this drug a much more attractive alternative than doxorubicin to be explored at high doses or as part of new drug combinations. This review addresses the clinical pharmacology, metabolism, and present role of ifosfamide in the treatment of locally advanced and/or metastatic soft tissue sarcomas, excluding gastrointestinal stromal tumors, the Ewing-like sarcomas, and other small blue round cell tumors. Furthermore, this review focuses on the anticipated growing role of ifosfamide in the development of new treatment strategies.
Insights
Ifosfamide offers a promising alternative to doxorubicin for treating soft tissue sarcomas due to its comparable efficacy and lack of cardiotoxicity. This review explores ifosfamide
Area of Science:
- Oncology
- Pharmacology
- Medical Chemistry
Background:
- Soft tissue sarcomas (STS) have poor treatment outcomes, with doxorubicin as standard therapy.
- Doxorubicin's cardiotoxicity limits its use, especially in combination with targeted therapies like VEGF inhibitors.
- VEGF inhibitor combinations with doxorubicin show high rates of cardiomyopathy.
Purpose of the Study:
- To review the clinical pharmacology, metabolism, and current role of ifosfamide in STS treatment.
- To highlight ifosfamide's potential as a safer alternative to doxorubicin.
- To discuss ifosfamide's anticipated role in developing new treatment strategies for STS.
Main Methods:
- Literature review of clinical pharmacology and metabolism of ifosfamide.
- Analysis of ifosfamide's efficacy and safety in treating locally advanced and metastatic STS.
- Examination of ifosfamide's potential in combination therapies.
Main Results:
- Ifosfamide demonstrates response rates comparable to doxorubicin.
- Ifosfamide lacks the cardiotoxicity associated with doxorubicin.
- Ifosfamide presents a safer option for high-dose or combination therapy.
Conclusions:
- Ifosfamide is an attractive alternative to doxorubicin for STS treatment due to its safety profile.
- Ifosfamide's lack of cardiotoxicity supports its exploration in novel therapeutic combinations.
- Ifosfamide is poised to play an increasing role in future STS treatment strategies.
