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Single agent Combination chemotherapy Single agent Doxorubicin
Doxorubicin (Adriamycin) 75 mg/m2 iv bolus q3w Santoro, A et al. Doxorubicin versus CYVADIC versus doxorubicin plus ifosfamide in first-line treatment of advanced soft tissue sarcomas: A randomized study of the European Organization for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group. J Clin Oncol 1995; 13:1537 (link to the article). Pegylated liposomal doxorubicin
Pegylated liposomal doxorubicin (Doxil) 50 mg/m2 iv over 1 h q4w Judson, I et al. Randomised phase II trial of pegylated liposomal doxorubicin (DOXIL(R)/CAELYX(R)) versus doxorubicin in the treatment of advanced or metastatic soft tissue sarcoma. a study by the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer 2001; 37:870 (link to the article). Ifosfamide
Ifosfamide 3 g/m2/d iv over 4 hrs d1-3 q3w van Oosterom, AT et al. Results of randomised studies of the EORTC Soft Tissue and Bone Sarcoma Group (STBSG) with two different ifosfamide regimens in first- and second-line chemotherapy in advanced soft tissue sarcoma patients. Eur J Cancer 2002; 38:2397 (link to the article). High dose ifosfamide
Ifosfamide 2 g/m2 iv over 2 hrs q12 hrs x 7 doses (total 14 g)
Mesna 500 mg/m2 mixed with first dose of ifosfamide iv over 2 hrs, followed by 2.4 g/m2/d civi x 4 days
Filgrastim (Neupogen) 5 mcg/kg sc qd starting on d4 Patel, SR et al. High-dose ifosfamide in bone and soft tissue sarcomas: results of phase II and pilot studiesdose response and schedule dependence. J Clin Oncol 1997; 15:2378 (link to the article). Gemcitabine
Gemcitabine (Gemzar) 1200 mg/m2 iv over 120 min d1, 8 q3w Maki RG et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcoma. J Clin Oncol 2007; 25:2755 (link to the article).
Combination chemotherapy (back to top) AI regimen 1
Doxorubicin (Adriamycin) 50 mg/m2 iv bolus d1
Ifosfamide 5 g/m2 iv over 24 hrs d1
Mesna 600 mg/m2 iv bolus before ifosfamide
Mesna 2.5 g/m2 mixed with ifosfamide iv over 24 hrs
Mesna 1.25 g/m2 iv over 12 hrs after ifosfamide
Q3w Le Cesne, A et al. Randomized phase III study comparing conventional-dose doxorubicin plus ifosfamide versus high-dose doxorubicin plus ifosfamide plus recombinant human granulocyte-macrophage colony-stimulating factor in advanced soft tissue sarcomas: a trial of the european organization for research and treatment of cancer/soft tissue and bone sarcoma group. J Clin Oncol 2000; 18:2676 (link to the article). AI regimen 2
Doxorubicin (Adriamycin) 60 mg/m2 civi over 72 hrs d1
Ifosfamide 1.5 g/m2/d iv over 2 hrs d1-4
Mesna 225 mg/m2 iv over 1 h before ifosfamide, 4 hrs and 8 hrs after ifosfamide
Filgrastim (Neupogen) 5 mcg/kg sc qd x 10 days starting on day 5
Q3w Worden, FP et al. Randomized phase II evaluation of 6 g/m2 of ifosfamide plus doxorubicin and granulocyte colony-stimulating factor (G-CSF) compared with 12 g/m2 of ifosfamide plus doxorubicin and G-CSF in the treatment of poor-prognosis soft tissue sarcoma. J Clin Oncol 2005; 23:105 (link to the article). AD
Doxorubicin (Adriamycin) 15 mg/m2/d civi d1-4
Dacarbazine (DTIC) 250 mg/m2/d civi d1-4
Q3w
Antman, K et al. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol 1993; 11:1276 (link to the article). MAID
Doxorubicin (Adriamycin) 15 mg/m2/d civi d1-4
Ifosfamide 2 g/m2/d civi d1-3
Dacarbazine (DTIC) 250 mg/m2/d civi d1-4
Mesna 2.5 g/m2/d civi d1-4
Q3w Antman, K et al. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol 1993; 11:1276 (link to the article). Antman, K et al. A Southwest Oncology Group and Cancer and Leukemia Group B phase II study of doxorubicin, dacarbazine, ifosfamide, and mesna in adults with advanced osteosarcoma, Ewing's sarcoma, and rhabdomyosarcoma. Cancer 1998; 82:1288 (link to the article). Gemcitabine + Docetaxel
Gemcitabine (Gemzar) 675-900 mg/m2 iv over 90 min d1, 8
Docetaxel (Taxotere) 100 mg/m2 iv over 1 h d8
Filgrastim (Neupogen) 5 mcg/kg sc qd d9-15
Q3w Maki RG et al. Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcoma. J Clin Oncol 2007; 25:2755 (link to the article).
Hensley, ML et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 2002; 20:2824 (link to the article). Leu, KM et al. Laboratory and clinical evidence of synergistic cytotoxicity of sequential treament with gemcitabine followed by docetaxel in the treatment of sarcoma. J Clin Oncol 2004; 22:1706 (link to the article). Ewing’s sarcoma and primitive neuroectodermal tumor of bone
Cyclophosphamide (Cytoxan) 1200 mg/m2 iv d1, followed by mesna
Doxorubicin (Adriamycin) 75 mg/m2 iv bolus d1, change to dactinomycin 1.25 mg/m2 iv d1 when total doxorubicin reaches 375 mg/m2
Vincristine 2 mg iv d1
Alternating with
Ifosfamide 1.8 g/m2/d iv d1-5, given with mesna
Etoposide (VP-16) 100 mg/m2/d iv d1-5
Q3w x 17 cycles Holcombe E et al. Addition of ifosfamide and etoposide to standard chemotherapy for Ewing’s sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med 2003; 348:694 (link to the article).
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