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Topotecan plus cyclophosphamide in adults with relapsed or refractory pediatric-type sarcoma: a retrospective analysis from the German Sarcoma Medical Oncology Group (AIO)

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Summary

Background To assess the efficacy and safety of topotecan and cyclophosphamide (TC) in adult patients with pediatric-type sarcoma subtypes who failed induction chemotherapy. Patients and methods Patients with pediatric sarcoma subtypes, refractory to or relapsed after at least one prior induction chemotherapy, inoperable, ECOG PS 0-2, with measurable, progressive disease (PD), adequate organ functions, who have been treated with TC combination were retrospectively analysed within the AIO and SAREZ/BMBF network. Results Thirty-nine patients, median age 28 years (18–58), 14 females, 25 males, have been identified. All patients had received induction treatment according to (inter)national study protocols. Second-line TC was applied in 33 patients (≥3rd-line in 6 patients). Twenty-three patients had refractory disease (evidence of PD during induction chemotherapy); 8 patients experienced an early relapse within 6 months as well as 8 patients after more than 24 months (late relapse). A median of 3 cycles (range, 1–6) had been applied and antitumor activity was: CR 2.6 %, PR 7.9 %, and disease stabilisation (SD) 26.3 %. PR lasted 32.8 months and median duration in patients with SD was 5 months (range, 2.0–14.7). The 3/6-months progression-free rates were 43.2 and 18.9 %. Conclusions Limited activity was seen in adult pts with refractory or relapsed pediatric-type sarcomas with the regimen which has proven activity in pediatric patients. Adults with refractory small cell sarcoma appear to have a similar dismal outcome as seen in pts with common adult-type histologies; however, a subset of patients has achieved long-lasting remissions on TC resulting in long-term survival.

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Acknowledgments

Presented at the European Society for Medical Oncology Annual Meeting, 23–27 September 2011, Stockholm.

Funding

German prospective relapse sarcoma registry (SAREZ) of the TranSaRNet supported by the BMBF (German Federal Ministry of Education and Research, No. 01GM1019).

Conflict of interest

The authors have declared no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent was not required.

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Authors and Affiliations

  1. Clinic for Internal Medicine II, Hematology, Oncology, Immunology, Catholic Hospital Consortium, Franziskus Hospital Bielefeld, Kiskerstrasse 26, Bielefeld, 33615, Germany

    Jörg Thomas Hartmann

  2. Department of Hematology and Oncology, University of Munich Medical Center, München, Germany

    R. D. Issels

  3. Department of Hematology and Medical Oncology, University Hospital of Erlangen, Erlangen, Germany

    K. San Nicolo & S. Krause

  4. Department of Hematology, Hemostaseology, Oncology, and Stem Sell Transplantation, Medical University of Hannover, Hannover, Germany

    V. Grünwald

  5. Department of Hematology and Oncology, Medical Center of Bremen-Mitte gGmbH, Bremen, Germany

    B. Hertenstein

  6. Department of Hematology, Medical Oncology and Pneumonology, University Hospital of Mainz, Mainz, Germany

    E. Papesch

  7. Department of Hematology, Oncology and Tumor Immunology, Charité - University Hospital Berlin, Campus Virchow-Klinikum, Berlin, Germany

    I. Sturm

Authors
  1. Jörg Thomas Hartmann
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  2. R. D. Issels
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  3. K. San Nicolo
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  4. V. Grünwald
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  7. S. Krause
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  8. I. Sturm
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Correspondence to Jörg Thomas Hartmann.

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Hartmann, J.T., Issels, R.D., Nicolo, K.S. et al. Topotecan plus cyclophosphamide in adults with relapsed or refractory pediatric-type sarcoma: a retrospective analysis from the German Sarcoma Medical Oncology Group (AIO). Invest New Drugs 33, 1115–1122 (2015). https://doi.org/10.1007/s10637-015-0267-x

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  • DOI: https://doi.org/10.1007/s10637-015-0267-x

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