Cyclical combination chemotherapeutic regimen in adult soft tissue sarcoma

A cyclical combination chemotherapeutic regimen of Adriamycin and cyclophosphamide alternating with actinomycin D and DTIC was administered to 20 evaluable patients with metastatic soft tissue sarcoma. Responses included four (20%) partial remissions and five (25%) patients with stable disease. There was a significant prolongation of survival for responding patients (median 42.5+ weeks) compared to patients with progressive disease (median 17.5 weeks). Principal toxicity was nausea and vomiting particularly with the actinomycin D/DTIC combination and four patients found this so intolerable they withdrew from study. These results are inferior to those reported for Adriamycin alone and other combinations. Further evaluation of the concept of sequential non-cross-resistant combinations would only seem appropriate if newer more active agents are identified and each combination is administered for a set duration before crossing over to the alternative regimen.