title: Tandem high-dose chemotherapy followed by autologous transplantation in patients with locally advanced or metastatic sarcoma.
abstract: BACKGROUND
  Patients with locally advanced or metastatic/recurrent soft tissue and Ewing's sarcoma (EWS) have few treatment options. The purpose of our phase II study was to assess the feasibility, safety and efficacy of tandem high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) in such patients.
  
  
  METHODS
  Thirteen patients were enrolled onto this study. The first cycle of HDCT consisted of doxorubicin (150 mg/m(2)) and ifosfamide (14 g/m(2)) mixed with mesna (14 g/m(2)), while the second cycle consisted of melphalan (150 mg/m(2)) and cisplatin (200 mg/m(2)).
  
  
  RESULTS
  Eleven out of 13 patients were able to complete both cycles of HDCT. No treatment-related mortality occurred and grade 3 or 4 toxicity was clinically tolerable. The 5-year progression-free survival (PFS) and overall survival (OS) for all patients was 23% (confidence interval, CI: 0-46%) and 31% (CI: 14-70%), respectively. Out of the four patients still alive, two had EWS and measurable disease at the time of ASCT and achieved a complete remission, remaining progression free 126 and 155 months after ASCT.
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility and safety of tandem HDCT in patients with high-risk or metastatic/recurrent sarcoma, with some patients achieving long-term PFS and OS.
authors: City of Hope Comprehensive Cancer Center, Division of Medical Oncology, 1500 E. Duarte Road, Duarte, CA 91010, USA.
authors: Ashkan
authors: A
authors: Lashkari
authors: Warren A
authors: WA
authors: Chow
authors: Frances
authors: F
authors: Valdes
authors: Lucille
authors: L
authors: Leong
authors: Vu
authors: V
authors: Phan
authors: Przemyslaw
authors: P
authors: Twardowski
authors: Neena
authors: N
authors: Kapoor
authors: Arturo
authors: A
authors: Molina
authors: Zaid
authors: Z
authors: Al-Kadhimi
authors: Paul
authors: P
authors: Frankel
authors: George
authors: G
authors: Somlo
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007124:Immunoenzyme Techniques; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D015080:Mesna / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000473:pathology / Q000628:therapy; D012516:Osteosarcoma / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D020011:Protective Agents / Q000008:administration & dosage; D012074:Remission Induction; D012208:Rhabdomyosarcoma / Q000473:pathology / Q000628:therapy; D012449:Safety; D012509:Sarcoma / Q000473:pathology / Q000628:therapy*; D012512:Sarcoma, Ewing / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020011:Protective Agents; D004317:Doxorubicin; D015080:Mesna; D002945:Cisplatin; D008558:Melphalan; D007069:Ifosfamide