Doxorubicin and dactinomycin therapy for advanced sarcomas

Doxorubicin and dactinomycin were administered to 25 patients with advanced sarcomas. Twenty-one were evaluable for response. There were six responses (two complete and four partial) (28%) and eight improvements. Responders survived longer than nonresponders, while those with improvements had intermediate survival. Toxic effects included leukopenia in 35% of administered courses, mucositis in 50% of the patients, and congestive heart failure in 21% of the patients. Plasma doxorubicin kinetics did not correlate with excess toxic effects in four patients studied. The response rates and durations of survival obtained with this combination are comparable to those obtained with doxorubicin alone. The marked increase in toxicity makes this combination less desirable than treatment with doxorubicin alone.