High-dose continuous-infusion ifosfamide in advanced well-differentiated/dedifferentiated liposarcoma

Sanfilippo, Roberta; Bertulli, Rossella; Marrari, Andrea; Fumagalli, Elena; Pilotti, Silvana; Morosi, Carlo; Messina, Antonella; Tos, Angelo Paolo Dei; Gronchi, Alessandro; Casali, Paolo G.

doi:10.1186/2045-3329-4-16

Cited by 45 publications

(34 citation statements)

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“…Among 28 patients treated with HDIFX in second/further line, the PR rate was 36% and median PFS was 4 months. We reported a similar PR rate for continuous-infusion HDIFX in well differentiated/dedifferentiated liposarcomas [ 25 ]. Nine patients were pretreated with first-line epirubicin–ifosfamide and we observed 4 PR (31% RECIST PR) out of 13 patients evaluable for response.…”

Section: Discussionmentioning

confidence: 93%

“…HDIFX is often used as a salvage regimen in synovial sarcoma and dedifferentiated liposarcoma, even in patients previously treated with standard-dose ifosfamide [ 25 – 29 ]. Furthermore, if compared with the classic ifosfamide schedule, the administration in the external portable device in a prolonged 14-days continuous infusion shows an excellent tolerability.…”

Section: Discussionmentioning

confidence: 99%

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Activity of anthracycline- and ifosfamide-based chemotherapy in a series of patients affected by advanced myxofibrosarcoma

et al. 2017

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BackgroundWe report on the activity of anthracycline-based and high-dose prolonged-infusion ifosfamide chemotherapy in a retrospective series of patients affected by advanced myxofibrosarcoma treated at Istituto Nazionale Tumori in Milan, Italy, and within the Italian Rare Cancer Network (RTR).MethodsAdvanced myxofibrosarcoma patients treated with anthracycline + ifosfamide and high-dose prolonged-infusion ifosfamide as a single agent from November 2001 to December 2016 were retrospectively reviewed. All pathological diagnosis were centrally reviewed by at least two expert pathologists. Response was evaluated by RECIST, and survival functions were computed.ResultsAmong 34 advanced myxofibrosarcoma patients, 13 were treated with front-line anthracycline + ifosfamide chemotherapy (male/female = 6/7, median age 54 years, range 33–72). Overall best response was: 4 partial responses, 3 stable diseases and 6 progressive diseases, with a median progression-free survival of 4 months. Twenty-eight patients received second/further line high-dose prolonged-infusion ifosfamide (male/female = 17/11, median age 55 years, range 27–75 years). We observed 10 partial responses, 4 stable diseases and 14 progressive diseases, with a median progression-free survival of 4 months. Median overall survival was 12 months.ConclusionsThis retrospective analysis suggests that the combination of anthracyclines and ifosfamide is active in myxofibrosarcoma. In patients already treated with a combination of anthracyclines and ifosfamide, high-dose prolonged-infusion ifosfamide showed activity as well.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Activity of anthracycline- and ifosfamide-based chemotherapy in a series of patients affected by advanced myxofibrosarcoma

et al. 2017

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“…51–53 In selected patients, a significant response to cytotoxic and/or targeted systemic therapies may prompt reconsideration of resection (VB).…”

Section: Resultsmentioning

confidence: 99%

Management of Recurrent Retroperitoneal Sarcoma (RPS) in the Adult: A Consensus Approach from the Trans-Atlantic RPS Working Group

2016

Ann Surg Oncol

145

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Introduction Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Surgery is the mainstay of curative therapy, but local recurrence is common. No recommendations concerning the best management of recurring disease have been developed so far. Although every effort should be made to optimize the initial approach, recommendations to treat recurring RPS will be helpful to maximize disease control at recurrence. Methods An RPS transatlantic working group was established in 2013. The goals of the group were to share institutional experiences, build large multi-institutional case series, and develop consensus documents on the approach to this difficult disease. The outcome of this document applies to recurrent RPS that is nonvisceral in origin. Included are sarcomas of major veins, undifferentiated pleomorphic sarcoma of psoas, ureteric leiomyosarcoma (LMS). Excluded are desmoids-type fibromatosis, angiomyolipoma, gastrointestinal stromal tumors, sarcomas arising from the gut or its mesentery, uterine LMS, prostatic sarcoma, paratesticular/spermatic cord sarcoma, Ewing sarcoma, alveolar/embryonal rhabdomyosarcoma, sarcoma arising from teratoma, carcinosarcoma, sarcomatoid carcinoma, clear cell sarcoma, radiation-induced sarcoma, paraganglioma, and malignant pheochromocytoma. Results Recurrent RPS management was evaluated from diagnosis to follow-up. It is a rare and complex malignancy that is best managed by an experienced multidisciplinary team in a specialized referral center. The best chance of cure is at the time of primary presentation, but some patients may experience prolonged disease control also at recurrence, when the approach is optimized and follows the recommendations contained herein. Conclusions International collaboration is critical for adding to the present knowledge. A transatlantic prospective registry has been established.

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“…Adriamycin or Epirubicin was used in 73% of patients:25% of them received full of the planned dose therapy, the other were treated with a reduced dose (ranging from10-25% of the theoric dose ) [8,9]. Ifosfamide as continous 14 days infusion q 28 days, was administered in 18 as first line( 29% of cases ) [10]. The combination between Antracycline and Ifosfamide + Mesna because of its high degree of toxicity was administered in 4 patients only for no more than 3 cycles (range 1-3).…”

Section: Resultsmentioning

confidence: 99%

“…Ifosfamide + Mesna in 14 days C.I. was utilized in 34 (54%) patients who progressed after first line chemotherapy [10]. Trabectedin has been approved since 2010 as second line therapy and 11 (17%) patients received treatment as second or further line of therapy as 24 hour infusion in Liposarcomas and leiomyosarcoma [13,14].…”

Section: Resultsmentioning

confidence: 99%

Metastatic soft tissue sarcomas (STS) in elderly patients: 18 years of monoinstitutional experience.

Comandone

Boglione

Giubellino

et al. 2017

JCO

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e22528 Background: Elderly people represent more than 50% of STS patients, but few data are available in this population and old patients in clinical studies are underrepresented or not included. Aim of this retrospective, monoinstitutional study is to describe the activity and feasibility of first and second line chemotherapy in elderly patients with metastatic STS. Methods: Patients older than 65, with metastatic STS of the scalp, trunk, girdles and extremities, treated and followed from February 1998 to December 2015 in an Italian referral Center for diagnosis and care of STS were included. Median Overall survival (OS) was the principal end point calculated from the start of chemotherapy to the last date of follow up or death. Response rate and toxicities related to type of administered chemotherapy were the secondary end points. Results: 134 patients (79 M, 55F) were considered, (65-70 y) 63%, (71- 75y) 25%, ( > 76 y)11% . STS histologies: mixoid and round cell liposarcomas (34%), leiomyosarcomas (25%), pleomorphic undifferentiated sarcomas (13%), Angiosarcoma (10%), Mixofibrosarcoma (6%), MPNST (4%), synovial sarcoma (2%), other histologies (6%). All the patients received at least one course chemotherapy (1-12). Mono CT was the preferred administered schedule (92%of cases). Median OS was 7.3 months; at the time of this analysis only 14 patients were alive (10%). In the first line therapy we recorded 1 CR, 14 PR and 43 SD. In second line therapy no CR, 4 PR, 23 SD. PR were recorded mainly in 65-70y old patients. Bad PS, low score in Comprehensive Geriatric Assesment (CGA), vulnerability, comorbidities, number of metastasis, were negative prognostic factors. No toxic death were recorded. 12% of the pts were recovered for febrile neutropenia, thrombocitopenia and mucositis . Conclusions: Our study confirms that elderly patients with metastatic STS is a difficult population to be treated. Only patients less aged, good PS, good GCA and 0-1 comorbidities can be treated with full dose of drug, generally with mono CT. Chemotherapy in elderly pts doesn’t produce a significant improvement in Median Survival and benefit observed support the routine use of citotoxic treatment in selected good performance status population.

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High-dose continuous-infusion ifosfamide in advanced well-differentiated/dedifferentiated liposarcoma

Cited by 45 publications

References 20 publications

Activity of anthracycline- and ifosfamide-based chemotherapy in a series of patients affected by advanced myxofibrosarcoma

Activity of anthracycline- and ifosfamide-based chemotherapy in a series of patients affected by advanced myxofibrosarcoma

Management of Recurrent Retroperitoneal Sarcoma (RPS) in the Adult: A Consensus Approach from the Trans-Atlantic RPS Working Group

Metastatic soft tissue sarcomas (STS) in elderly patients: 18 years of monoinstitutional experience.

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