High-dose continuous-infusion ifosfamide in advanced well-differentiated/dedifferentiated liposarcoma

Area of Science:

• Oncology
• Medical Oncology
• Pharmacology

Background:

• Liposarcomas are the most common soft-tissue sarcomas (STS), with WD/DD subtypes showing poor response to chemotherapy.
• Limited active agents exist for WD/DD liposarcoma, including anthracyclines, ifosfamide, and trabectedin.
• High-dose ifosfamide (HDIFX) is active but toxic; continuous infusion (ci) may mitigate toxicity.

Purpose of the Study:

• To evaluate the efficacy and tolerability of continuous infusion high-dose ifosfamide (ciHDIFX) in advanced liposarcoma.
• To assess activity in patients previously treated with standard chemotherapy regimens.

Main Methods:

• 28 patients with advanced WD/DD liposarcoma received ciHDIFX at 14 g/m2 over 14 days every 4 weeks.
• 86% of patients had prior chemotherapy, including anthracyclines and ifosfamide.

Main Results:

• Seven partial responses (PR) and two minor responses (MR) were observed, all in DDLPS.
• Six of nine patients with PR or MR had stable disease (SD) with prior anthracycline plus ifosfamide.
• Median progression-free survival was 7 months; manageable side effects included myelosuppression, nausea, and fatigue.

Conclusions:

• ciHDIFX demonstrates activity in WD/DDLPS, including in patients pre-treated with anthracyclines and ifosfamide.
• The ciHDIFX regimen appears better tolerated than previously reported HDIFX regimens.