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Neoadjuvant Chemotherapy in High-R ... | Article | H1 Connect

Evaluations

Perioperative chemotherapy remains controversial in soft tissue sarcoma (STS); however, myxoid liposarcoma (MLPS) may exhibit increased chemosensitivity, and some data suggest a role in high-risk patients. This phase III trial randomized patients with high-risk extremity or trunk wall STS to receive a standard anthracycline plus ifosfamide neoadjuvant regimen or a histology-tailored regimen followed by limb-sparing surgery. Patients with high-grade MLPS on the histology-tailored arm received trabectedin, an alkylating agent that binds the minor groove of DNA with activity in many fusion-positive sarcoma subtypes. The trial showed similar disease-free survival in the standard and histology-tailored arms, but overall survival was significantly higher in patients treated with the standard anthracycline-based regimen (5-year overall survival 65.9 versus 75.7%, P = 0.02).

This Recommendation is of an article referenced in a Faculty Review also written by Richard Riedel.

Relevant Specialties

  • Oncology

    Oncologic Drugs | Sarcomas

Clinical Trials

Trial registry title:
Localized High-Risk Soft Tissue Sarcomas Of The Extremities And Trunk Wall In Adults: An Integrating Approach Comprising Standard Vs Histotype-Tailored Neoadjuvant Chemotherapy
Identifier:
NCT01710176

Sponsor:

Italian Sarcoma Group
Phase:
Phase 3
Gender:
All
Min Age:
18 Years
Max Age:
N/A
Condition:
Localized High-risk Soft Tissue Sarcomas of the Extremities and Trunk Wall in Adults
Interventions:
epirubicin 60 mg/m2/day (days 1, 2) and ifosfamide 3 g/m2/day (days 1, 2, 3), gemcitabine 900 mg/m2 (days 1 and 8) and docetaxel 75 mg/m2 (day 8), trabectedin 1.3 mg/m2, high-dose ifosfamide 14 g/m2, given in in 14 days, etoposide 150 mg/m2/day (days 1, 2, 3) and ifosfamide 3g/m2/day (days 1, 2, 3), gemcitabine 1800 mg/m2 (day 1) and dacarbazine 500 mg/m2 (day 1)
Countries:
Italy, Spain
Official Title:
Localized High-Risk Soft Tissue Sarcomas Of The Extremities And Trunk Wall In Adults: An Integrating Approach Comprising Standard Vs Histotype-Tailored Neoadjuvant Chemotherapy

Full Registry Information