Consolidation with high-dose chemotherapy and stem cell support for responding patients with metastatic soft tissue sarcomas: prospective, single-institutional phase II study.
Prognosis of patients with metastatic soft tissue sarcoma remains poor. Whether high-dose chemotherapy with stem cell support improves the long-term outcome for these patients is debatable. We present a prospective, single-institutional phase II study that enrolled 34 soft tissue sarcoma patients with advanced and/or metastatic disease. After four courses of chemotherapy consisting of doxorubicin and ifosfamide, responding patients in at least partial response (PR) were treated with high-dose chemotherapy (n=9); all other patients continued chemotherapy for two more cycles. After standard chemotherapy, PR (n=10), stable disease (SD, n=6) and progressive disease (PD, n=14) were attained for the evaluable patients. Twenty-nine patients died and five are alive with the disease. Median PFS was 11.6 months (range 8-15) for patients treated with high-dose chemotherapy (n=9) vs 5.6 months (range 0-19) for patients treated with standard chemotherapy. Median OS was 23.7 months (range 12-34) vs 10.8 months (range 0-39), respectively. The subgroup of patients treated with high-dose chemotherapy gained significant survival benefit. Nevertheless, high-dose chemotherapy as a possible consolidation strategy remains highly investigational.
Kasper
B
B
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany. mail@berndkasper.de
Scharrenbroich
I
I
Schmitt
T
T
Wuchter
P
P
Dietrich
S
S
Ho
A D
AD
Egerer
G
G
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D012509:Sarcoma / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate
D004317:Doxorubicin; D007069:Ifosfamide