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Adding ifosfamide to doxorubicin for advanced soft tissue sarcoma doubled the response rate and delayed progression but did not lengthen survival and caused much more toxicity, so doxorubicin alone remains the default unless shrinkage is needed.
Phase 3 trial of 455 patients with advanced high-grade soft tissue sarcoma randomised to doxorubicin 75 mg per square metre alone or with ifosfamide 10 g per square metre and growth factor support.
Median overall survival was 14.3 versus 12.8 months (hazard ratio 0.83, not significant), median progression-free survival 7.4 versus 4.6 months, and response 26 versus 14 percent; febrile neutropenia and other grade 3 to 4 toxicities were far more frequent with the combination.
Single-agent doxorubicin is the standard first-line palliative treatment for most advanced sarcomas, with doxorubicin-ifosfamide reserved for fit patients in whom tumour shrinkage matters.
Shares Myxofibrosarcoma, Malignant peripheral nerve sheath tumour (MPNST), Undifferentiated pleomorphic sarcoma (UPS), Leiomyosarcoma.
Shares Synovial sarcoma, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), The Lancet Oncology.
Shares Leiomyosarcoma, Soft tissue sarcoma of the extremity (localised and advanced), The Lancet Oncology, Doxorubicin.
Shares Myxofibrosarcoma, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares Synovial sarcoma, Undifferentiated pleomorphic sarcoma (UPS), Leiomyosarcoma, Soft tissue sarcoma of the extremity (localised and advanced).
Shares Leiomyosarcoma, Soft tissue sarcoma of the extremity (localised and advanced), Doxorubicin.
Shares Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares Myxofibrosarcoma, Malignant peripheral nerve sheath tumour (MPNST), Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).