Gemcitabine in advanced adult soft-tissue sarcomas. A phase II study of the EORTC Soft Tissue and Bone Sarcoma Group

Svancárová, L; Blay, Jean‐Yves; Judson, Ian; Hoesel, Q.G.C.M. van; Oosterom, A.T. van; Cesne, Axel Le; Keizer, H. J.; Hermans, C; Glabbeke, M. van; Verweij, Jaap; Hogendoorn, Pancras C.W.; Nielsen, Ole Steen

doi:10.1016/s0959-8049(01)00408-7

Cited by 111 publications

(57 citation statements)

References 15 publications

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“…20 The response rates of single-agent gemcitabine in patients with soft tissue and bone sarcomas in 5 phase 2 trials were 3%, 3%, 5.5%, 11%, and 18%, with a median of 5.5%. [21][22][23][24][25] We have used cryoimmunotherapy for treatment of bone and soft tissue sarcomas since 2008. 26 Combining tumour cryotreatment with dendritic cell therapy promotes tumour-specific immune responses and enhances systemic immune responses.…”

Section: Discussionmentioning

confidence: 99%

Late Recurrence of Osteosarcoma: A Report of Two Cases

Igarashi

Yamamoto

Shirai

et al. 2014

J Orthop Surg (Hong Kong)

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We report 2 cases of late recurrence of osteosarcoma after 6 and 7 years. One patient had pulmonary metastasis, and the other had soft tissue recurrence. Both patients underwent complete resection and chemotherapy. The first patient achieved complete remission and remained disease-free 47 months later and had no limitation in his daily life. The second patient had a re-recurrence and underwent further resection and chemotherapy. He remained diseasefree 35 months later and could walk using a T-handled walking cane.Key words: neoplasm metastasis; neoplasm recurrence, local; osteosarcoma introduction Long-term survival of patients with osteosarcoma is 10% to 20% after surgical resection alone. With

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Section: Discussionmentioning

confidence: 99%

Late Recurrence of Osteosarcoma: A Report of Two Cases

Igarashi

Yamamoto

Shirai

et al. 2014

J Orthop Surg (Hong Kong)

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“…The combination of gemcitabine and docetaxel was also proven to be effective in advanced STS, particularly in patients with uterine leiomyosarcoma (LMS) (3). While single-agent gemcitabine exhibited only modest activity, the overall response rates in phase II trials combining gemcitabine with docetaxel were in the range of 16-53% in this patient group (3)(4)(5)(6). A higher efficacy with superior progression-free survival (PFS) and overall survival (OS) was also demonstrated with this combination in several comparative trials (3,7,8).…”

Section: Introductionmentioning

confidence: 88%

Gemcitabine in combination with paclitaxel for advanced soft-tissue sarcomas

Sonnenblick

Eleyan

Peretz

et al. 2015

Molecular and Clinical Oncology

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Abstract.A limited number of chemotherapeutic agents have been found to be active against advanced soft-tissue sarcomas (STSs), particularly sarcomas that have progressed following doxorubicin treatment. The aim of this retrospective study was to determine the response to treatment with gemcitabine plus paclitaxel in patients with STSs. Data were collected on all patients with advanced non-resectable STS who were treated with a fixed dose 700 mg/m 2 gemcitabine in combination with 70 mg/m 2 paclitaxel on days 1 and 8 every 3 weeks. A total of 30 patients were included, with a median age of 56.4 years (range, 40-70 years). The gemcitabine/paclitaxel combination was well tolerated, with an overall response in 27% and a clinical benefit in 57% of the patients. The median progression-free survival was 6.1 months and the overall survival was 14.3 months. In conclusion, gemcitabine plus paclitaxel was found to be tolerable and effective in patients with advanced STSs. IntroductionSoft-tissue sarcomas (STSs) are a heterogeneous family of malignancies originating from mesenchymal tissues. Patients who present with advanced-stage STS or develop disease recurrence following initial resection carry a poor prognosis, since the majority of chemotherapeutic agents have not achieved any survival benefit in this disease. However, ~30% of patients treated with doxorubicin achieve an objective response and the response rates may increase to 35-40% when doxorubicin is combined with ifosfamide (1,2). The combination of gemcitabine and docetaxel was also proven to be effective in advanced STS, particularly in patients with uterine leiomyosarcoma (LMS) (3). While single-agent gemcitabine exhibited only modest activity, the overall response rates in phase II trials combining gemcitabine with docetaxel were in the range of 16-53% in this patient group (3-6). A higher efficacy with superior progression-free survival (PFS) and overall survival (OS) was also demonstrated with this combination in several comparative trials (3,7,8). Therefore, it became common practice in several sarcoma centers to initiate combination treatment, hypothesizing synergy between gemcitabine and docetaxel. Myelosupression is the primary toxicity (grade 3-4 neutropenia in 17%, grade 3 anemia in 25% and severe thrombocytopenia in 10% of the patients) associated with this type of treatment (9). In addition, grade 3 non-hematological toxicities, including fatigue and myalgia, developed in 25% of the patients. Patients with advanced sarcoma are usually heavily pretreated, with limited bone marrow tolerance and impaired quality of life. Paclitaxel and docetaxel share the same mechanisms of action and were found to exhibit similar efficacies in certain types of cancer, such as breast and lung cancer. Paclitaxel has been proven to be more tolerable when administered weekly, according to studies on breast cancer (10-12). For example, in a prospective randomized trial assessing different schedules and regimens of paclitaxel vs. docetaxel in adjuvant therapy for breast ca...

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“…Only two of these, docetaxel [17] and cyclophosphamide [18], have been directly compared with doxorubicin or ifosfamide, respectively, but both exhibited inferior antitumor activity. Drugs tested in a single-arm study design include gemcitabine [19,20], paclitaxel [21,22], temozolomide [23], mitoxantrone [24], methotrexate [25], topotecan [26], and etoposide [25], but all were judged to lack substantial antitumor activity.…”

Section: Single-agent Treatmentmentioning

confidence: 99%

Using Single-Agent Therapy in Adult Patients with Advanced Soft Tissue Sarcoma Can Still Be Considered Standard Care

2005

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Learning ObjectivesAfter completing this course, the reader will be able to:1. Discuss the current status of the chemotherapeutic treatment of advanced soft tissue sarcomas in adult patients.2. Explain the pitfalls in trial design when reading published papers on performed clinical studies.3. Discuss the importance of identifying the several subtypes comprising the group of soft tissue sarcomas. AbstractThe group of soft tissue sarcomas in adult patients is a heterogeneous group with more than 40 different subtypes. While local treatment remains the mainstay for localized disease, systemic chemotherapy can importantly contribute in the treatment of advanced soft tissue sarcoma. For patients with metastatic disease, chemotherapy is a palliative treatment in the vast majority of the cases. In this setting, toxicity should not outweigh the potential benefits resulting from chemotherapy. In patients with locally advanced disease too extensive for local treatment, systemic chemotherapy can contribute to cure, provided that tumor shrinkage renders subsequent optimal local treatment possible. In these cases, chemotherapeutic regimens yielding the highest response rates achievable should be used. In the last decades, several randomized studies have aimed to determine whether combination regimens yield benefit over single-agent treatment in terms of response rate and overall survival. This review addresses the current available data on chemotherapy for adult patients with soft tissue sarcoma, excluding gastrointestinal stromal tumor, the Ewing-like sarcomas, and other small blue round cell tumors. In addition, it is increasingly recognized that future research in soft tissue sarcoma should focus on the identification of tumor factors that can serve as targets for treatment and that the diverse tumor subtypes should be analyzed separately for their sensitivity to systemic treatment. This review also focuses on these and other strategies that will hopefully lead to better outcomes in this disease entity in the near future. The Oncologist 2005;10:833-841 Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S.

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Gemcitabine in advanced adult soft-tissue sarcomas. A phase II study of the EORTC Soft Tissue and Bone Sarcoma Group

Cited by 111 publications

References 15 publications

Late Recurrence of Osteosarcoma: A Report of Two Cases

Late Recurrence of Osteosarcoma: A Report of Two Cases

Gemcitabine in combination with paclitaxel for advanced soft-tissue sarcomas

Using Single-Agent Therapy in Adult Patients with Advanced Soft Tissue Sarcoma Can Still Be Considered Standard Care

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