Combined vindesine and razoxane shows antimetastatic activity in advanced soft tissue sarcomas.
BACKGROUND
Razoxane and vindesine were shown to suppress distant metastasis in animal systems. Both drugs affect main steps of the metastatic cascade. Therefore, a pilot study was performed to study the influence of these drugs on the dynamics of metastasis in advanced soft tissue sarcomas (STS). This study was now updated.


METHODS
Twenty-three patients with unresectable (n = 7) and oligometastatic STS (n = 16) received a basic treatment with razoxane and vindesine supported by radiotherapy and occasionally by surgery. Long-term treatment was intended in patients with metastatic disease. The cumulative number of new metastases after 6 and 9 months were determined. Thirty-six patients with comparable stages of STS treated with contemporary chemotherapy served as non-randomized, retrospective controls. The prognostic parameters of the groups were comparable.


RESULTS
In patients receiving razoxane and vindesine, the median number of new metastases after 6 months was 0 (range, 0-40) and after 9 months likewise 0 (0-70). The corresponding numbers in the control group were 4.5 (range, 0-40) and 9 (0->100) (P < 0.001). The progression-free survival at 6 months was 74% in the study group and 23% in the controls. The median survival time from the occurrence of the first metastasis or the time of unresectability was 20+ months (range, 8-120+) versus 9 months (range, 2-252) (P < 0.001). The combined treatment was associated with a low to moderate toxicity.


CONCLUSIONS
Trimodal treatment with razoxane, vindesine, and radiotherapy is feasible in patients with unresectable primaries and early metastatic STS. The combination inhibits the development of remote metastases in a majority of the patients and prolongs survival.
Rhomberg
Walter
W
Department of Radiation Oncology, Academic Teaching Hospital, Carinagasse 47, Feldkirch, 6800, Austria. walter.rhomberg@gmx.at
Eiter
Helmut
H
Schmid
Franz
F
Saely
Christoph H
CH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D009362:Neoplasm Metastasis / Q000517:prevention & control* / Q000532:radiotherapy; D010865:Pilot Projects; D011878:Radiotherapy; D011929:Razoxane / Q000008:administration & dosage; D012509:Sarcoma / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D016896:Treatment Outcome; D014751:Vindesine / Q000008:administration & dosage
D011929:Razoxane; D014751:Vindesine