Tandem high-dose chemotherapy followed by autologous transplantation in patients with locally advanced or metastatic sarcoma.

Abstract

BACKGROUND:

Patients with locally advanced or metastatic/recurrent soft tissue and Ewing's sarcoma (EWS) have few treatment options. The purpose of our phase II study was to assess the feasibility, safety and efficacy of tandem high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) in such patients.

PATIENTS AND METHODS:

Thirteen patients were enrolled onto this study. The first cycle of HDCT consisted of doxorubicin (150 mg/m(2)) and ifosfamide (14 g/m(2)) mixed with mesna (14 g/m(2)), while the second cycle consisted of melphalan (150 mg/m(2)) and cisplatin (200 mg/m(2)).

RESULTS:

Eleven out of 13 patients were able to complete both cycles of HDCT. No treatment-related mortality occurred and grade 3 or 4 toxicity was clinically tolerable. The 5-year progression-free survival (PFS) and overall survival (OS) for all patients was 23% (confidence interval, CI: 0-46%) and 31% (CI: 14-70%), respectively. Out of the four patients still alive, two had EWS and measurable disease at the time of ASCT and achieved a complete remission, remaining progression free 126 and 155 months after ASCT.

CONCLUSION:

Our study demonstrates the feasibility and safety of tandem HDCT in patients with high-risk or metastatic/recurrent sarcoma, with some patients achieving long-term PFS and OS.

• Authors: Ashkan Lashkari, Warren A Chow, Frances Valdes, Lucille Leong, Vu Phan, Przemyslaw Twardowski, Neena Kapoor, Arturo Molina, Zaid Al-Kadhimi, Paul Frankel, George Somlo
• Journal: Anticancer research (Anticancer Res) Vol. 29 Issue 8 Pg. 3281-8 (Aug 2009) ISSN: 1791-7530 [Electronic] Greece
• PMID: 19661346 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• Protective Agents
• Doxorubicin
• Mesna
• Cisplatin
• Melphalan
• Ifosfamide

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Neoplasms (secondary, therapy)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Disease Progression
• Doxorubicin (administration & dosage)
• Feasibility Studies
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Ifosfamide (administration & dosage)
• Immunoenzyme Techniques
• Male
• Melphalan (administration & dosage)
• Mesna (administration & dosage)
• Neoplasm Recurrence, Local (pathology, therapy)
• Neoplasm Staging
• Neuroectodermal Tumors, Primitive, Peripheral (pathology, therapy)
• Osteosarcoma (pathology, therapy)
• Prognosis
• Prospective Studies
• Protective Agents (administration & dosage)
• Remission Induction
• Rhabdomyosarcoma (pathology, therapy)
• Safety
• Sarcoma (pathology, therapy)
• Sarcoma, Ewing (pathology, therapy)
• Survival Rate
• Transplantation, Autologous
• Treatment Outcome
• Young Adult