Phase I/II study of docetaxel, ifosfamide, and doxorubicin in advanced, recurrent, or metastatic soft tissue sarcoma (STS).
BACKGROUND
Based on reports of the efficacy of docetaxel (T) in STS, we undertook a phase I/II trial to determine the response rate (RR), dose-limiting toxicity (DLT), and maximum tolerated dose (MTD) of addition of T to doxorubicin (A) and ifosfamide (I) in advanced STS.


METHODS
Patients with advanced, recurrent, or metastatic STS, without prior chemotherapy, were enrolled in a dose escalation trial. Dose levels: I-A 40 mg/m(2); I 4.0 gm/m(2); T 40 mg/m(2), II-A 50; I 5.0; T 50, III-A 60; I 6.0; T 60, and IV-A 75; I 7.5; T 75. MTD was defined as the dose producing DLTs in >or=2 of 3-6 patients treated.


RESULTS
21 patients were accrued. Median age: 55 (28-78) years.


RESULTS
leiomyosarcoma 10, spindle cell sarcoma 3, synovial sarcoma 2, angiosarcoma 1, fibrous histiocytoma 1, epitheliod hemangio-endothelioma 1, and 3 not specified. MTD was level III (A 60, I 6.0, and T 60). DLT was myelosuppression. All grade 4 toxicities were hematologic. Patients received median 2 cycles (range 2-9). Eight patients (38%) achieved partial response (PR). PR occurred after six cycles in 5 patients. 18 patients died. Median overall survival: 17 months (95% CI, 9.1-33.6 months).


CONCLUSIONS
The recommended Phase II dose of this combination is level III: A 60 mg/m(2), I 6.0 g/m(2), T 60 mg/m(2), with mesna and granulocyte-colony stimulating factor. The RR is similar to that of AI in other trials, but the survival is better than anticipated.
Suppiah
Revathi
R
Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk R35, Cleveland, Ohio 44195, USA. suppiar@ccf.org
Wood
Laura
L
Elson
Paul
P
Budd
George T
GT
D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage
D018906:Antineoplastic Agents, Alkylating; D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin; D007069:Ifosfamide