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Trying to match neoadjuvant chemotherapy to sarcoma subtype backfired: standard epirubicin-ifosfamide gave better disease-free and overall survival than the tailored regimens, and in doing so provided evidence that neoadjuvant anthracycline-ifosfamide itself helps high-risk patients.
Phase 3 trial of 287 patients with high-risk localised soft tissue sarcoma of the limbs or trunk wall in five histological subtypes randomised to three cycles of neoadjuvant epirubicin-ifosfamide or a histotype-tailored regimen (gemcitabine-docetaxel, trabectedin, high-dose ifosfamide, etoposide-ifosfamide or gemcitabine-dacarbazine).
The trial stopped early for futility: 46-month disease-free survival was 62 percent with standard chemotherapy against 38 percent with tailored regimens, and overall survival 89 versus 64 percent, with the difference driven by undifferentiated pleomorphic sarcoma and other subtypes.
Three cycles of neoadjuvant anthracycline-ifosfamide is a reasonable standard for fit patients with high-risk limb or trunk sarcoma, particularly undifferentiated pleomorphic sarcoma.
Shares ISG-STS 1001, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares Synovial sarcoma, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced), The Lancet Oncology.
Shares ISG-STS 1001, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares ISG-STS 1001, Soft tissue sarcoma of the extremity (localised and advanced).
Shares Undifferentiated pleomorphic sarcoma (UPS), The Lancet Oncology.
Shares Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares Synovial sarcoma, Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).
Shares Undifferentiated pleomorphic sarcoma (UPS), Soft tissue sarcoma of the extremity (localised and advanced).