A SOUTHWEST-ONCOLOGY-GROUP AND CANCER AND LEUKEMIA GROUP-B PHASE-II STUDY OF DOXORUBICIN, DACARBAZINE, IFOSFAMIDE, AND MESNA IN ADULTS WITHADVANCED OSTEOSARCOMA, EWINGS-SARCOMA, AND RHABDOMYOSARCOMA

BACKGROUND. Ewing's sarcomas, osteosarcomas, and rhabdomyosarcomas are significantly more responsive to chemotherapy than other sarcomas. Ad juvant chemotherapy is used routinely based on data from randomized tr ials. Although a percentage of children with locally advanced or metas tatic tumors remain curable, few data exist regarding tile tumor's nat ural history or response and survival in adults. METHODS, This Phase I I study evaluated doxorubicin, dacarbazine, ifosfamide, and mesna (MAI D) in adults with inoperable or metastatic Ewing's sarcoma, rhabdomyos arcoma, Or osteosarcoma. RESULTS, Between 1987-1991, 81 patients were entered; 69 patients were eligible. One patient died of neutropenic in fection. Ten patients (14%) responded completely and 34 patients (49%) had a complete or partial response. Response rates were significantly higher for patients with Ewing's sarcoma and rhabdomyosarcoma than fo r those with osteosarcoma (77%, 64%, and 26%, respectively; P < 0.005) . Although there were no significant differences in progression free s urvival by histology, survival for patients with Ewing's sarcoma was s ignificantly longer than for patients with osteosarcoma (P = 0.004.) A t the time of last follow-up, 7 patients (10%) were alive without prog ression: 3 with Ewing's sarcoma, 1 with osteosarcoma, a-id 3 with rhab domyosarcoma. CONCLUSIONS. MAID chemotherapy is an active regimen in a dults with advanced or metastatic Ewing's sarcoma and rhabdomyosarcoma . Although there was no direct comparison with a doxorubicin and cispl atin-based regimen, the response rate and survival in patients with os teosarcoma suggest that doxorubicin and cisplatin-based chemotherapy w ould remain the accepted initial chemotherapy regimen. For patients wi th rhabdomyosarcoma and Ewing's sarcoma, 10-20% of patients remained d isease free at 5 years. (C) 1998 American Cancer Society.