We performed a retrospective review of our data obtained with the original
CYVADIC regimen in 31 consecutive patients with advanced
soft tissue sarcomas. The treatment consisted of
cyclophosphamide 500 mg/m2 i.v. from day 1,
vincristine 1.5 mg/m2 in days 1 and 5,
doxorubicin 50 mg/m2 i.v. on day 1, and
dAcarbazine 250 mg/m2 i.v. from days 1 to 5, repeated every 3 weeks. An objective response was observed in 11/31 patients (35.5%). There were 2 complete remissions (6.5%) lasting 23 and 2 months respectively and 9 partial responses (median duration 7 months, range 1-23). No change was observed in 14 patients, and 6 patients showed progression after a median of 2 cycles of
chemotherapy. Toxicity was similar to that already described with this regimen, with
alopecia,
nausea,
vomiting and myelosuppression being the most important side effects. In particular, the median WBC nadir was 1,900/mm3 (range 400-3,600/mm3) whereas the platelet nadir was 181,000/mm3 (range 80,000-358,000/mm3); no patient developed
congestive heart failure, and no treatment related death was observed. Still today, after 10 years of use, the
CYVADIC regimen is very widely employed as a standard treatment for recurrent or metastatic
soft tissue sarcomas, although the original positive results have been confirmed only by a few authors. In our retrospective analysis of a totally unselected population of patients, we too observed a lower activity which is, however, according to a recent review, similar to the mean value of responses obtained in the whole population of treated patients reported in the literature.