Investigational New Drugs

, Volume 31, Issue 6, pp 1592–1601

A non-comparative phase II study of dose intensive chemotherapy with doxorubicin and ifosfamide followed by high dose ICE consolidation with PBSCT in non-resectable, high grade, adult type soft tissue sarcomas

  • Jörg Thomas Hartmann
  • M. Horger
  • T. Kluba
  • A. Königsrainer
  • P. de Zwart
  • C. Hann von Weyhern
  • F. Eckert
  • W. Budach
  • C. Bokemeyer
PHASE II STUDIES

DOI: 10.1007/s10637-013-0027-8

Cite this article as:
Hartmann, J.T., Horger, M., Kluba, T. et al. Invest New Drugs (2013) 31: 1592. doi:10.1007/s10637-013-0027-8

Summary

The objective was to determine the role of dose intensive induction chemotherapy in patients with soft tissue sarcomas (STS) that were considered unresectable. Treatment consisted of 2–3 cycles of doxorubicin (Dox) and ifosfamide (Ifo) followed by high dose chemotherapy with ifosfamide, carboplatin, etoposide (HD-ICE) plus peripheral blood stem cell transplantation (PBSCT). 30 out of 631 consecutive patients, median age 46 years (21–62), with high grade STS were included. 29 patients completed at least 2 cycles of Dox/Ifo. HD-ICE was withheld because of progressive disease (PD) in 5 patients, neurotoxicity in 6 cases, insufficient peripheral blood stem cell (PBSC) mobilization, complete remission (CR) and refusal in 1 patient each. HD-ICE was associated with non-haematological grade III toxicity including emesis, mucositis, fever, neurotoxicity, and transaminase level elevation. Two additional patients attained a partial response after HD-ICE. Overall, 24 of 30 (80 %) patients underwent surgery, with complete tumor resections in 19 patients (63 % of all patients, 79 % of the operated subgroup); however, 2 of these required amputation. After a median follow up period of 50 months in surviving patients (range, 26–120), 5-year PFS and OS rates were 39 % and 48 %, respectively. Induction chemotherapy plus consolidation HD-ICE is generally feasible, but is associated with significant neurotoxicity. The advantage of HD-ICE over conventional dose chemotherapy plus external beam radiation therapy (EBRT) in non-resectable disease remains unproven.

Keywords

Soft tissue sarcoma High dose chemotherapy Locally advanced Radiation Surgery Autologous stem cell transplantation 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jörg Thomas Hartmann
    • 1
  • M. Horger
    • 2
  • T. Kluba
    • 3
  • A. Königsrainer
    • 4
  • P. de Zwart
    • 5
  • C. Hann von Weyhern
    • 6
  • F. Eckert
    • 7
  • W. Budach
    • 8
  • C. Bokemeyer
    • 9
    • 10
  1. 1.Medical Oncology, Comprehensive Cancer Center North, Universitätsklinikum Schleswig-Holstein, Campus KielChristian-Albrechts-UniversityKielGermany
  2. 2.Diagnostic RadiologyEberhard-Karls-UniversityTuebingenGermany
  3. 3.Orthopedic SurgeryEberhard-Karls-UniversityTuebingenGermany
  4. 4.General Surgery and TransplantationEberhard-Karls-UniversityTuebingenGermany
  5. 5.Clinic for Accident and Reconstructive Surgery, BG KlinikTuebingenGermany
  6. 6.Institute of PathologyStaedtisches Klinikum MuenchenMuenchenGermany
  7. 7.Department of Radiation OncologyEberhard-Karls-UniversityTuebingenGermany
  8. 8.Department of Radiation OncologyHeinrich-Heine UniversityDuesseldorfGermany
  9. 9.Department of Oncology, Hematology, Rheumatology and ImmunologyEberhard-Karls-UniversityTuebingenGermany
  10. 10.Department of Oncology, Hematology and Bone Marrow TransplantationUniversity Medical Center Hamburg-EppendorfHamburgGermany

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