Chemotherapy in advanced soft tissue sarcomas

  • Jaap Verweij
  • Cees J. van Groeningen
  • Herbert M. Pinedo
Part of the Cancer Treatment and Research book series (CTAR, volume 44)

Abstract

With local recurrence rates of 40%–80% [1] and most of these relapses occurring within 3 years [2], soft tissue sarcomas have always been a difficult tumor type for adequate local treatment. Although sophisticated surgical techniques and the addition of postoperative high-dose radiotherapy have considerably reduced the number of local recurrences in extremity lesions [2–5], the inability to apply the necessary high doses of irradiation precluded a decrease in local recurrence in truncal lesions by using the combination of surgery and radiotherapy. Besides, soft tissue sarcomas metastasize by (apparently early) hematogeneous spreading, most frequently to the lungs, which can only partly be prevented by optimal local control of the primary tumor. Therefore, distant metastases still occur in a considerable number of patients, for whom systemic treatment with chemotherapy will be considered.

Keywords

Clin Oncol Soft Tissue Sarcoma Uterine Sarcoma Soft Tissue Sarcoma Patient Advanced Soft Tissue Sarcoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Enneking WF, Spanier SS, Malawer MM: The effect of the anatomic setting on the results of surgical procedures for soft-part sarcomas of the thigh. Cancer 47:1005–1022, 1981.PubMedCrossRefGoogle Scholar
  2. 2.
    Lindberg RD, Martin RG, Ramsdahl MM: Surgery and postoperative radiotherapy in the treatment of soft tissue sarcomas in adults. AJR Ther Nucl Med 123:123–129, 1975.Google Scholar
  3. 3.
    Gerson R, Shiu MH, Hajdu SI: Sarcoma of the buttock: a trend toward limb-salvage resection. J Surg Oncol 19:238–242, 1982.PubMedCrossRefGoogle Scholar
  4. 4.
    Leibel SA, Tranbaugh RF, Wara WM, et al.: Soft tissue sarcomas of the extremities: survival and patterns of failure with conservative surgery and postoperative irradiation compared to surgery alone. Cancer 50:1076–1083, 1982.PubMedCrossRefGoogle Scholar
  5. 5.
    Suit HD, Mankin HJ, Wood WC, Proppe KH: Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma. Cancer 55:2659–2667, 1985.PubMedCrossRefGoogle Scholar
  6. 6.
    Bonadonna G, Beretta G, Tancini G, et al.: Adriamycin (NSC-123127) studies at the Instituto Nazionale Tumori, Milan. Cancer Chemother Rep 6:231–245, 1975.Google Scholar
  7. 7.
    Verweij J, van Oosterom AT, Pinedo HM: Melanomas, soft tissue and bone sarcomas. Eur J Cancer Clin Oncol [Suppl] 4:75–85, 1985.Google Scholar
  8. 8.
    Borden EC, Amato DA, Rosenbaum Ch, et al.: Randomized comparison of three adriamycin regimens for metastatic soft tissue sarcomas. J Clin Oncol 5:840–850, 1987.PubMedGoogle Scholar
  9. 9.
    O’Bryan RM, Luce JK, Talley RW: Phase II evaluation of adriamycin in human neoplasma. Cancer 32:1–8, 1973.PubMedCrossRefGoogle Scholar
  10. 10.
    Mitts DL, Gerhardt H, Armstrong D, et al.: Chemotherapy for advanced soft tissue sarcomas: results of phase I and II cooperative studies. Tex Med 75:43–47, 1979.PubMedGoogle Scholar
  11. 11.
    Chlebowski RT, Paroly WS, Pugh RP: Adriamycin given as a weekly schedule without a loading course: clinically effective with reduced incidence of cardiotoxicity. Cancer Treat Rep 64:49–51, 1980.Google Scholar
  12. 12.
    Gerlach JH, Bell DR, Karakousis C, et al.: P-glycoprotein in human sarcoma: evidence for multidrug resistance. J Clin Oncol 5:1452–1460, 1987.PubMedGoogle Scholar
  13. 13.
    Benjamin RS, Yap BS: Infusion chemotherapy for soft tissue sarcomas. In: Baker LH (ed), Soft tissue sarcomas. Boston: Martinus Nijhoff, 1983, pp 109–116.Google Scholar
  14. 14.
    Bramwell VHC, Mouridsen HT, Mulder JH, Somers R, van Oosterom AT, Santoro A, Thomas D, Sylvester R, Markham D: Carminomycin vs adriamycin in advanced soft tissue sarcomas: an EORTC randomized phase II study. Eur J Cancer Clin Oncol 19:1097–1104, 1983.PubMedCrossRefGoogle Scholar
  15. 15.
    Mouridsen HT, Bastholt L, Somers R, Santoro A, Bramwell V, Mulder JH, van Oosterom AT, Buesa J, Pinedo HM, Thomas D, Sylvester R: Adriamycin versus epirubicin in advanced soft tissue sarcomas: a randomized phase II/phase III study of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer Clin Oncol 23:1477–1483, 1987.PubMedCrossRefGoogle Scholar
  16. 16.
    Bodey GP, Yap BS, Ajani J: Clinical trials of 4′-epidoxorubicin. In: Proceedings of the 13th international congress on chemotherapy 215:23–26, 1983.Google Scholar
  17. 17.
    Bertrand M, Multhauf P, Bartolucci A, Ellison D, Gockerman J: Phase II study of aclarubicin in previously untreated patients with advanced soft tissue sarcoma: a South-Eastern Cancer Study Group trial. Cancer Treat Rep 69:725–726, 1985.PubMedGoogle Scholar
  18. 18.
    Raymond V, Magill GB, Wissel PS, Cheng EW, Ochoa M, Young CW: Phase II trial of deoxydoxorubicin in patients with soft tissue sarcoma. Proc Am Soc Clin Oncol 5:146, 1986.Google Scholar
  19. 19.
    Wissel PS, Magill GB, Raymond V, Well S, Sordillo P, Cheng E: 4′Demethoxydaunorubicin in advanced soft tissue sarcomas: an update with emphasis on patients without prior doxorubicin. Proc Am Soc Clin Oncol 3:259, 1984.Google Scholar
  20. 20.
    Presant CA, Gans R, Bartolucci AA: Treatment of metastatic sarcomas with mitoxantrone. Cancer Treat Rep 68:813–814, 1984.PubMedGoogle Scholar
  21. 21.
    Bull FE, von Hoff DD, Balcerzak SP, Stephens RL, Panetierre FJ: Phase II trial of mitoxantrone in advanced sarcomas: a South-West Oncology Group study. Cancer Treat Rep 69: 231–233, 1985.PubMedGoogle Scholar
  22. 22.
    Gottlieb JA, Benjamin RS, Baker LH, et al.: Role of DTIC (NSC-45338) in the chemotherapy of sarcomas. Cancer Treat Rep 60:199–203, 1976.PubMedGoogle Scholar
  23. 23.
    Buesa J, Mouridsen H, van Oosterom AT, Steward WT, Verweij J, Thomas D: High-dose DTIC in advanced soft tissue sarcoma of the adult: a phase II study of the EORTC Soft Tissue and Bone Sarcoma Group. Proc ECCO 4:235, 1987.Google Scholar
  24. 24.
    Hoefer-Janker H, Scheef W, Gunther U, et al.: Erfahrungen mit der fraktionierten Ifosfamid-Stoss Therapie bei generalisierten malignen Tumoren. Med Welt 26:972–979, 1977.Google Scholar
  25. 25.
    Klein HO, Wickramanayake PD, Coerper CL, et al.: High-dose ifosfamide and mesna as continuous infusion over five days: a phase I/II trial. Cancer Treat Rev 10:167–173, 1983.PubMedCrossRefGoogle Scholar
  26. 26.
    Czownicki A, Utracka-Hutka B: Contribution to the treatment of malignant tumours with ifosfamide. In: Burkert H, Voight HC (eds), Proceedings of the international Holoxan symposium. Düsseldorf: ASTA-Werke, 1977, pp 109–111.Google Scholar
  27. 27.
    Antman KM, Montella D, Rosenbaum Ch, Schwen M: Phase II trial of ifosfamide with mesna in previously treated metastatic sarcoma. Cancer Treat Rep 69:499–504, 1985.PubMedGoogle Scholar
  28. 28.
    Wiltshaw E, Westbury G, Harmer C, McKinna A, Fisher C: Ifosfamide plus mesna with and without adriamycin in soft tissue sarcoma. Cancer Chemother Pharmacol [Suppl 2] 18: S10–12, 1986.CrossRefGoogle Scholar
  29. 29.
    Bramwell VHC, Mouridsen H, Santoro A, Blackledge G, Somers R, Verweij J, Dombernowsky P, Onsrud M, Thomas D, Sylvester R, van Oosterom AT: Cyclophosphamide versus ifosfamide: final report of a randomized phase II trial in adult soft tissue sarcomas. Eur J Cancer Clin Oncol 23:311–321, 1987.PubMedCrossRefGoogle Scholar
  30. 30.
    Sordillo PP, Magill GB, Welt S: Phase II trial of methylglyoxal-bis-guanylhydrazone (methyl-GAG) in patients with soft-tissue sarcomas. Am J Clin Oncol (CCT) 8:316–318, 1985.CrossRefGoogle Scholar
  31. 31.
    Thigpen JT, Blessing JA, Homesley HD, Hacker N, Curry SL: Phase II trial of piperazinedione in patients with advanced or recurrent uterine sarcoma: a Gynecologic Oncology Group Study. Am J Clin Oncol (CCT) 8:350–352, 1985.CrossRefGoogle Scholar
  32. 32.
    Amato DA, Borden EC, Shiraki M, Enterline HT, Rosenbaum C, Davis HL, Paul AR, Stevens CM, Lerner HJ: Evaluation of bleomycin, chlorozotocin, MGBG, and bruceantin in patients with advanced soft tissue sarcoma, bone sarcoma, and mesothelioma. Invest New Drugs 3:397–401, 1985.PubMedCrossRefGoogle Scholar
  33. 33.
    Chan C, Bartolucci A, Brenner D, Presant C, Davila E, Carpenter J, Greco A, Clamon G, Moore J: Phase II trial of diaziquone in anthracycline-resistant adult soft tissue and bone sarcoma patients: a South-Eastern Cancer Study Group trial. Cancer Treat Rep 70:427–428, 1986.PubMedGoogle Scholar
  34. 34.
    Cowan JD, Gehan E, Rivkin SE, Jones SE: Phase II trial of bisantrene in patients with advanced sarcoma: a South-West Oncology Group study. Cancer Treat Rep 70:685–686, 1986.PubMedGoogle Scholar
  35. 35.
    Wissel P, Magill G, Sordillo P, Cheng E, Hakes T, Applewhite A: A phase II trial of mitomycin C in advanced soft tissue sarcomas. Proc Am Soc Clin Oncol 5:146, 1986.Google Scholar
  36. 36.
    Ajani JA, Dimery I, Chawla SP, Pinnamaneni K, Benjamin RS, Legha S, Krakoff IH: Phase II studies of homoharringtonine in patients with advanced malignant melanomas, sarcoma, and head and neck, breast and colorectal carcinomas. Cancer Treat Rep 70:375–379, 1986.PubMedGoogle Scholar
  37. 37.
    Thigpen JT, Blessing JA, Wilbanks GD: Cisplatin as second-line chemotherapy in the treatment of advanced or recurrent leiomyosarcoma of the uterus: a phase II trial of the Gynecologic Oncology Group. Am J Clin Oncol (CCT) 9:18–20, 1986.CrossRefGoogle Scholar
  38. 38.
    Sordillo PP, Magill GB, Brenner J, Cheng EW, Dosik M, Yagoda A: A phase II evaluation of cisplatin in previously untreated patients with soft tissue sarcomas. Cancer 59:884–886, 1987.PubMedCrossRefGoogle Scholar
  39. 39.
    Budd GT, Balcerzak S, Mortimer J, Fletcher W: SWOG 8465: high-dose cisplatin for advanced sarcomas. Proc Am Soc Clin Oncol 6:137, 1987.Google Scholar
  40. 40.
    Rouëssé JG, van Oosterom AT, Capellaere P, Kerbrat P, van Groeningen CJ, Thomas D, Benshahar D: Phase II study of 1,2,4-triglycidyl urasol (TGU) in advanced soft tissue sarcoma: a trial of the EORTC Soft Tissue and Bone Sarcoma Cooperative Group. Eur J Cancer Clin Oncol 23:1413–1414, 1987.PubMedCrossRefGoogle Scholar
  41. 41.
    Dombernowsky P, Buesa J, Pinedo HM, Santoro A, Mouridsen HT, Somers R, Bramwell V, Onsrud M, Rouëssé J, Thomas D, Sylvester R: VP-16 in advanced soft tissue sarcoma: a phase II study of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer Clin Oncol 23:579–580, 1987.PubMedCrossRefGoogle Scholar
  42. 42.
    Zalupski M, Pazdur R, Samson M, Baker L: Phase II clinical evaluation of fludarabine in soft tissue and osteosarcomas. Proc Am Soc Clin Oncol 6:135, 1987.Google Scholar
  43. 43.
    Harris J, Das Gupta T, Vogelzang N, Badrinath K, Bonomi P, Desser R, Locker G, Blough R, Johnson C: Treatment of soft tissue sarcoma with fibroblast interferon (beta-interferon): an American Cancer Society/Illinois Cancer Council study. Cancer Treat Rep 70:293–294, 1986.PubMedGoogle Scholar
  44. 44.
    Edmonson JH, Long HJ, Creagan ET, Frytak S, Sherwin SA, Chang MN: Phase II study of recombinant gamma-interferon in patients with advanced non-osseous sarcomas. Cancer Treat Rep 71:211–213, 1987.PubMedGoogle Scholar
  45. 45.
    Thigpen JT, Blessing JA, Orr JW, DiSaia J: Phase II trial of cisplatin in the treatment of patients with advanced or recurrent mixed mesodermal sarcomas of the uterus: a Gynecologic Oncology Group study. Cancer Treat Rep 70:271–274, 1986.PubMedGoogle Scholar
  46. 46.
    Gershenson DM, Kavanagh JJ, Copeland LJ, Edwardo CL, Stringer CA, Wharton JT: Cisplatin therapy for disseminated mixed mesodermal sarcoma of the uterus. J Clin Oncol 5:618–621, 1987.PubMedGoogle Scholar
  47. 47.
    Morrow CP, Bundy BN, Hoffman J, Sutton G, Homesley H: Adriamycin chemotherapy for malignant mixed mesodermal tumor of the ovary: a Gynecologic Oncology Group study. Am J Clin Oncol (CCT) 9:24–26, 1986.CrossRefGoogle Scholar
  48. 48.
    Slayton E, Blessing JA, DiSaia PJ, Christopherson WA: Phase II trial of etoposide in the management of advanced or recurrent mixed mesodermal sarcomas of the uterus: a Gynecologic Oncology Group study. Cancer Treat Rep 71:661–662, 1987.PubMedGoogle Scholar
  49. 49.
    Gottlieb JA, Baker LH, Quagliana JM, Luce JK, Whitecar JP, Sinkovics JG, Rivkin SE, Brownlee R, Frei E: Chemotherapy of sarcomas with a combination of adriamycin and dimethyl triazeno imidazole carboxamide. Cancer 30:1632–1638, 1972.PubMedCrossRefGoogle Scholar
  50. 50.
    Omura GA, Major FJ, Blessing JA, Sedlacek TV, Thigpen JT, Creasman WT, Zaino RJ: A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer 52:626–632, 1983.PubMedCrossRefGoogle Scholar
  51. 51.
    Schoenfeld DA, Rosenbaum Ch, Horton J, Wolter JM, Falkson G, De Conti RC: A comparison of adriamycin versus vincristine and adriamycin and cyclophosphamide versus vincristine, actinomycin-D and cyclophosphamide for advanced sarcoma. Cancer 50:2757–2762, 1982.PubMedCrossRefGoogle Scholar
  52. 52.
    Muss HB, Bundy B, DiSaia PJ, Homesley HD, Fowler WC, Creasman W, Yordan E: Treatment of recurrent or advanced uterine sarcoma: a randomized trial of doxorubicin versus doxorubicin and cyclophosphamide (a phase III trial of the Gynecologic Oncology Group). Cancer 55:1648–1653, 1985.PubMedCrossRefGoogle Scholar
  53. 53.
    Baker LH, Frank J, Fine G, Balcerak SP, Stephens RL, Stuckey WJ, Rivkin S, Saiki J, Ward JH: Combination chemotherapy using adriamycin, DTIC, cyclophosphamide and actinomycin-D for advanced soft tissue sarcomas: a randomized comparative trial—a phase III Southwest Oncology Group study (7613). J Clin Oncol 5:851–861, 1987.PubMedGoogle Scholar
  54. 54.
    Saiki JH, Baker LH, Rivkin SE, Shahbender S, Fletcher WS, Athens JW, Balcerak SP, Bonnet JD: A useful high-dose intermittent schedule of adriamycin and DTIC in the treatment of advanced sarcomas. Cancer 58:2196–2197, 1986.PubMedCrossRefGoogle Scholar
  55. 55.
    Baker LH, Green S, Ryan J, Rosenberg B, Balcerak S: SWOG 8024: combind modality therapy for disseminated soft tissue sarcoma, phase III. Proc Am Soc Clin Oncol 6:138, 1987.Google Scholar
  56. 56.
    Yap BS, Baker LH, Sinkovics JG, Rivkin SE, Bottomley R, Thigpen T, Burgess MA, Benjamin RS, Bodey GP: Cyclophosphamide, vincristine, adriamycin and DTIC (CYVADIC) combination chemotherapy for the treatment of advanced sarcomas. Cancer Treat Rep 64: 93–98, 1980.PubMedGoogle Scholar
  57. 57.
    Yap BS, Burgess MA, Sinkovics JG, Benjamin RS, Bodey GP: A 5-year experience with cyclophosphamide, vincristine, adriamycin and DTIC (CYVADIC) chemotherapy in 169 adults with advanced soft tissue sarcoma. Proc Am Soc Clin Oncol 22:534, 1981.Google Scholar
  58. 58.
    Yap BS, Sinkovics JG, Burgess MA, Benjamin RS, Bodey GP: The curability of advanced soft tissue sarcomas in adults with chemotherapy. Proc Am Soc Clin Oncol 2:239, 1983.Google Scholar
  59. 59.
    Pinedo HM, Bramwell VHC, Mouridsen H, Somers R, Vendrik CPJ, Santoro A, Buesa J, Wagener Th, van Oosterom AT, van Unnik JAM, Sylvester R, de Pauw M, Thomas D, Bonadonna G: CYVADIC in advanced soft tissue sarcoma: a randomized study comparing two schedules. Cancer 53:1825–1832, 1984.PubMedCrossRefGoogle Scholar
  60. 60.
    Dalley DN, Levi JA, Nesbitt RA, Tattersall MHM, Woods RL, Fox RM, Aroney RS: Cyclical combination chemotherapeutic regimen in adult soft tissue sarcoma. Cancer Clin Trials 4:163–165, 1981.PubMedGoogle Scholar
  61. 61.
    Presant CA, Lowenbraun S, Bartolucci AA, Smalley RV, the Southeastern Cancer Study Group: Metastatic sarcoma: chemotherapy with adriamycin, cyclophosphamide and methotrexate alternating with actinomycin-D, DTIC and vincristine. Cancer 47:457–465, 1981.PubMedCrossRefGoogle Scholar
  62. 62.
    Karakousis CP, Rao U, Park HG: Combination chemotherapy (CYVADIC) in metastatic soft tissue sarcomas. Eur J Cancer Clin Oncol 18:33–36, 1982.PubMedCrossRefGoogle Scholar
  63. 63.
    Kerzel W, König HJ, Walter M, Arnold I: Zytostatische Kombinationsbehandlung fortgeschrittener Sarkome: Ergebnisse einer prospektiv angelegten Studie. Tumor Diagn Ther 6:180–184, 1985.Google Scholar
  64. 64.
    Bui NB, Chauvergne J, Hocke C, Durand M, Brunei R, Coindre JM: Analysis of a series of sixty soft tissue sarcomas in adults treated with a cyclophosphamide-vincristine-adriamycin-dacarbazine (CYVADIC) combination. Cancer Chemother Pharmacol 15:82–85, 1985.PubMedGoogle Scholar
  65. 65.
    Schuette J, Mouridsen H, Santoro A, Steward W, van Oosterom AT, Somers R, Blackledge G, Verweij J, Rouëssé J, Green JA, Pinedo HM, Kaye SB, Kerbrat H, Wagener T, Thomas D, Sylvester R: Adriamycin and ifosfamide, a new effective combination in advanced soft tissue sarcoma. Proc ECCO 4:232, 1987.Google Scholar
  66. 66.
    Pinedo HM, Verweij J: The treatment of soft tissue sarcomas with focus on chemotherapy: a review. Radiother Oncol 5:193–205, 1986.PubMedCrossRefGoogle Scholar
  67. 67.
    Elias AD, Antman KH: Doxorubicin, ifosfamide and dacarbazine (AID) with mesna uroprotection for advanced untreated sarcoma: a phase I study. Cancer Treat Rep 70:827–833, 1986.PubMedGoogle Scholar
  68. 68.
    Elias AD, Ryan L, Aisner J, Antman KH: Doxorubicin, ifosfamide and DTIC (AID) for advanced untreated sarcomas. Proc Am Soc Clin Oncol 6:134, 1987.Google Scholar
  69. 69.
    Klippstein TH, Mitrou PS, Kochendörfer KJ, Bergmann L: High-dose adriamycin and cis-platinum in advanced soft tissue sarcomas and invasive thymomas: a pilot study. Cancer Chemother Pharmacol 13:78–81, 1984.PubMedCrossRefGoogle Scholar
  70. 70.
    Hartlapp JH, Münch HJ, Illinger HJ, Wolter H, Jensen JC: Alternatives to CYVADIC combination therapy of soft tissue sarcomas. Cancer Chemother Pharmacol [Suppl 2] 18: S20-S23, 1986.CrossRefGoogle Scholar
  71. 71.
    Edmonson JH, Hahn RG, Schutt AJ, Bisel HF, Ingle JN: Cyclophosphamide, doxorubicin and cisplatin combined in the treatment of advanced sarcomas. Med Pediatr Oncol 11:319–321, 1983.PubMedCrossRefGoogle Scholar
  72. 72.
    Piver MS, Lele SB, Patsner B: Cis-diamminedichloroplatinum plus dimethyl-triazenoimidazole carboxamide as second- and third-line chemotherapy for sarcomas of the female pelvis. Gynecol Oncol 23:371–375, 1983.CrossRefGoogle Scholar
  73. 73.
    Seltzer V, Kaplan B, Vogl S, Spitzer M: Doxorubicin and cisplatin in the treatment of advanced mixed mesodermal uterine sarcoma. Cancer Treat Rep 68:1389–1390, 1984.PubMedGoogle Scholar
  74. 74.
    Moore N, Fine S, Sturgeon J: Malignant mixed mesodermal tumors of the ovary: the Princess Margaret Hospital experience. Proc Am Soc Clin Oncol 5:114, 1986.Google Scholar
  75. 75.
    Jansen RLH, van der Burg MEL, Verweij J, Stoter G: Cyclophosphamide, hexamethyl-melamine, adriamycin and cisplatin combination chemotherapy in mixed mesodermal sarcoma of the female genital tract. Eur J Cancer Clin Oncol 23:1131–1133, 1987.PubMedCrossRefGoogle Scholar
  76. 76.
    Rouëssé JG, Friedman S, Sevin DM, Le Chevalier Th, Spielmann ML, Contesso G, Sarrazin DM, Genin JR: Preoperative induction chemotherapy in the treatment of locally advanced soft tissue sarcomas. Cancer 60:296–300, 1987.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers, Boston 1989

Authors and Affiliations

  • Jaap Verweij
  • Cees J. van Groeningen
  • Herbert M. Pinedo

There are no affiliations available

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