Two Too Hard On Soft-Tissue Cancers

Soft tissue sarcoma dual therapy does not extend life

(RxWiki News) Cancers that appear in the soft tissues of the body are very rare. In fact, they are seen in only about 5 people out of every 100,000. A recent study looked at the best way to treat this cancer.

Using a powerful combination of two chemotherapy agents – doxorubicin (brand names Adriamycin, Rubex) and ifosfamide (Mitoxana) – does not help soft-tissue cancer patients live longer.

Because this dual therapy is so toxic, it’s not recommended for most patients.

"Ask which chemotherapy drugs are being used on you."

A phase III trial, led by Professor Winette van der Graaf from Nijmegen, The Netherlands, aimed to see if doubling up on the chemotherapy could be effective in shrinking the tumor and extending life.

A total of 455 people between the ages of 18 and 60 participated in the trial. They were randomly selected to receive either doxorubicin by itself or in combination with ifosfamide.

Participants were given this treatment every 3 weeks until the disease started to progress (get worse) or six cycles had been given.

Following 56 months, Dr. van der Graff said there was no major difference in lifespan (overall survival) between the two groups.

Those in the combination group lived a median of 14.3 months, compared to 12.8 months for those who received only doxorubicin.

The combined therapy did prolong the time during which the disease didn’t get worse, what’s known as progression-free survival - 7.4 months versus 4.6 months for those receiving only one agent. The response rate was also higher – 26.5 vs. 13.6 percent.

The dual therapy was substantially more toxic, though.

As a result of the fact that overall survival was not impacted, Dr. van der Graff does not recommend the combined chemotherapy regimen for people with advanced disease. She noted that it may be used to shrink the tumor(s) in patients younger than 60 years old, but the toxicity issue should be weighed.

Single therapy with doxorubicin remain the standard of care for soft-tissue cancers, she noted.

“As always, the pros and cons of combination therapy should be discussed with the patient”, Dr. van der Graff said.

Doxorubicin is used to treat a number of cancers, including bladder, breast, lung, stomach and ovarian cancer, as well as lymphoma and certain types of leukemia, multiple myeloma and soft-tissue cancers.

Ifosfamide is approved to treat germ cell testicular cancer, bone and soft tissue sarcomas.

Results from this trial were presented at the ESMO 2012 Congress of European Society of Medical Oncology.

Before being published in a peer-reviewed journal, all research is considered preliminary.


Review Date: 
October 8, 2012