First-line treatment in advanced or metastatic disease: one size fits all or adapted to specific histiotypes?

Seddon, Beatrice

doi:10.1097/cco.0000000000000301

Cited by 5 publications

(2 citation statements)

References 67 publications

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“…As a traditional method of cancer treatment, chemotherapy has been used in STSs for more than 50 years since the introduction of doxorubicin in the 1970s. Currently, chemotherapeutic drugs, such as anthracyclines, ifosfamide, trabectedin, gemcitabine, paclitaxel, dacarbazine, and eribulin, have therapeutic effects in STSs and are widely used in clinical treatment ( Seddon, 2016 ; Bleloch et al, 2017 ; Frezza et al, 2017 ; Hatcher et al, 2017 ; Smrke et al, 2020 ). Here, we comprehensively reviewed the clinical trial results of various drugs for STSs to accurately describe the efficacy of them in STSs.…”

Section: Efficacy Of Different Drugs In Stssmentioning

confidence: 99%

Chemotherapeutic drugs for soft tissue sarcomas: a review

Tian

Yao

2023

Front. Pharmacol.

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Despite the low incidence of soft tissue sarcomas (STSs), hundreds of thousands of new STS cases are diagnosed annually worldwide, and approximately half of them eventually progress to advanced stages. Currently, chemotherapy is the first-line treatment for advanced STSs. There are difficulties in selecting appropriate drugs for multiline chemotherapy, or for combination treatment of different STS histological subtypes. In this study, we first comprehensively reviewed the efficacy of various chemotherapeutic drugs in the treatment of STSs, and then described the current status of sensitive drugs for different STS subtypes. anthracyclines are the most important systemic treatment for advanced STSs. Ifosfamide, trabectedin, gemcitabine, taxanes, dacarbazine, and eribulin exhibit certain activities in STSs. Vinca alkaloid agents (vindesine, vinblastine, vinorelbine, vincristine) have important therapeutic effects in specific STS subtypes, such as rhabdomyosarcoma and Ewing sarcoma family tumors, whereas their activity in other subtypes is weak. Other chemotherapeutic drugs (methotrexate, cisplatin, etoposide, pemetrexed) have weak efficacy in STSs and are rarely used. It is necessary to select specific second- or above-line chemotherapeutic drugs depending on the histological subtype. This review aims to provide a reference for the selection of chemotherapeutic drugs for multi-line therapy for patients with advanced STSs who have an increasingly long survival.

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Section: Efficacy Of Different Drugs In Stssmentioning

confidence: 99%

Chemotherapeutic drugs for soft tissue sarcomas: a review

Tian

Yao

2023

Front. Pharmacol.

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“…Ifosfamide is a member of the oxazaphosphorine family of alkylating agents and is an established systemic treatment in both soft-tissue sarcomas (STS) and bone sarcomas (BS), rare heterogenous malignant tumours of mesenchymal origin [ 1 ]. In STS, ifosfamide is often given in combination with doxorubicin as first-line treatment for locally advanced disease [ 2 ]. Whilst the combination does not confer an overall survival advantage over doxorubicin alone, the addition of ifosfamide significantly increases PFS and doubles radiological responses [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Continuous 14 Day Infusional Ifosfamide for Management of Soft-Tissue and Bone Sarcoma: A Single Centre Retrospective Cohort Analysis

Carter

Milić

McDerra

et al. 2020

Cancers

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Ifosfamide is used to treat soft-tissue sarcoma (STS) and bone sarcoma (BS), with improved efficacy at doses above 9 g/m2/cycle. To mitigate treatment-associated toxicity with higher doses, continuous infusional ifosfamide is increasingly used. However, clinical outcome data remain limited. Single-centre retrospective analysis of patients treated with four-weekly infusional ifosfamide (14 g/m2/14d) between August 2012 and February 2019 was conducted. Radiological response, progression-free survival (PFS), overall survival (OS) and toxicity were evaluated. Eighty patients were treated—46 with STS and 34 with BS. Patients received a median of three cycles of infusional ifosfamide (1–24). Overall disease control rate (DCR) in STS was 50% (23 of 46 patients), with a median PFS of 3.8 months, and median OS of 13.0 months. In synovial sarcoma (SS), DCR was 80% (12/15), median PFS 8.1 months and median OS 20.9 months. Overall DCR in BS (34 patients) was 30%, with a median PFS of 2.5 months and median OS of 6.2 months. Five patients (6%) stopped treatment due to toxicity alone within the first two cycles. A further 10 patients stopped treatment due to toxicity during later treatment cycles (12%) and 18 patients (23%) required dose modification. Forty-five patients (56%) experienced grade (G) 3/4 haematological toxicity, with 12 episodes of febrile neutropenia and one treatment-related death. Twenty-seven patients (34%) experienced G3/4 non-haematological toxicity, most commonly nausea and vomiting (10, 13%). In summary, infusional ifosfamide has efficacy in STS, most notable in SS. Benefit appears limited in BS. Treatment is associated with toxicity that requires specialist supportive care.

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A closer look at the natural history and recurrence patterns of high-grade truncal/extremity leiomyosarcomas: A multi-institutional analysis from the US Sarcoma Collaborative

et al. 2020

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First-line treatment in advanced or metastatic disease: one size fits all or adapted to specific histiotypes?

Abstract: The review shows that at present there is insufficient evidence to support the concept of adapting choice of first-line chemotherapy in advanced or metastatic STS to specific histiotypes.

Cited by 5 publications

References 67 publications

Chemotherapeutic drugs for soft tissue sarcomas: a review

Chemotherapeutic drugs for soft tissue sarcomas: a review

Continuous 14 Day Infusional Ifosfamide for Management of Soft-Tissue and Bone Sarcoma: A Single Centre Retrospective Cohort Analysis

A closer look at the natural history and recurrence patterns of high-grade truncal/extremity leiomyosarcomas: A multi-institutional analysis from the US Sarcoma Collaborative

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