Table 1.
Options for First-Line Chemotherapy in Patients With Advanced STS
| Treatment | Response Rate | Median OS, Months | Study |
|---|---|---|---|
| Single-agent regimen | |||
| Doxorubicin (60-75 mg/m2 every 3 wk) | 16%-27% | 7.7-12.0 | Bramwell 200016 |
| Lorigan 200721 | |||
| Epirubicin (75 mg/m2) | 18% | 4.0 | Mouridsen 198718 |
| Ifosfamide (5 g/m2 over 24 h every 3 wk) | 10%-25% | 12.0 | van Oosterom 200219 |
| High-dose ifosfamidea | 25%-38% | 10.2-18.5 | van Oosterom 200219 |
| Buesa 199820 | |||
| Temozolomide | |||
| (Oral bid × 5 d every 4 wk)b | 8% | 13.2 | Talbot 200315 |
| (Oral every d × 6 wk; then 3 wk off treatment)b | 16% | 8.1 | Garcia del Muro 200522 |
| Dacarbazine (1.2 g/m2 every 3 wk) | 18% | NR | Buesa 199129 |
| Combination regimens | |||
| Doxorubicin (50 mg/m2) + ifosfamide (5 g/m2) every 3 wk | 21%-28% | 13.8-14.0 | Santoro 199524 |
| Le Cesne 200028 | |||
| Doxorubicin (60 mg/m2) + ifosfamide (7.5 g/m2 over 2 d) every 3 wk | 34% | ∼11.5 | Edmonson 199323 |
| Doxorubicin (60 mg/m2) + dacarbazinec | 17%-30% | 8.0-12.0 | Borden 198717 |
| Antman 199325 | |||
| Mesna, doxorubicin, ifosfamide, and dacarbazine (MAID)d | 32% | 13.0 | Antman 199325 |
| Gemcitabine (900 mg/m2 on d 1 and 8) + docetaxel (100 mg/m2) on d 8 every 3 wk | 16% | 17.9 | Maki 200726 |
| Gemcitabine (800 mg/m2) + vinorelbine (25 mg/m2) on d 1 and 15 every 4 wk | 13% | 75% (12-mo OS) | Dileo 200727 |
Abbreviations: bid, twice daily; NR, not reported; OS, overall survival; STS, soft tissue sarcoma.
High-dose ifosfamide regimens included 9 g/m2 over 3 days every 3 weeks or 14 g/m2 over 6 days every 4 weeks.
Temozolomide was administered orally at a loading dose of 200 g/m2, then every 12 hours at 90 mg/m2 for 4.5 days every 4 weeks, or it was administered at doses of 75 mg/m2 or 100 mg/m2 once daily for 6 weeks followed by a 3-week treatment break before the next cycle.
Dacarbazine was administered intravenously every 3 weeks at a dose of 250 mg/m2/day every 5 days or 1000 mg/m2/day every 4 days.
MAID was comprised of doxorubicin at a dose of 60 mg/m2 and dacarbazine at a dose of 1000 mg/m2 infused continuously over 4 days plus ifosfamide at a dose of 7.5 g/m2 and mesna at a dose of 10 g/m2 infused continuously over 3 or 4 days. The ifosfamide dose was subsequently reduced to 6 g/m2 due to unacceptable myelosuppression after 154 of 374 patients had been accrued.