TREATMENT OF ADVANCED REFRACTORY SARCOMAS WITH IFOSFAMIDE AND ETOPOSIDE COMBINATION CHEMOTHERAPY

Chemotherapy options for resistant advanced-stage sarcomas are limited and in most cases disappointing. In a phase II study, we treated 26 c onsecutive patients with refractory advanced sarcoma with ifosfamide a nd etoposide combination chemotherapy. All patients had received prior doxorubicin- and/or cyclophosphamide-based chemotherapies. Seventeen patients were male and 9 were female. The patients' median age was 35 years (ranger 19-67 years). A total of 24 patients were eligible for e valuation of responses. Seven patients had a complete response (CR) (2 9.1%), 3 had a partial response (PR) (12.5%), 3 had stable disease (SD ) (12.5%), and II had progressive disease (PD) (45.9%). An overall 41. 6% objective response was achieved. Median time to treatment failure w as 13.3 months. A total of 108 cycles of therapy were evaluable for ev aluation of toxicity Myelosuppression, observed in 55.5% of the treatm ent courses, was the major dose-limiting toxicity. Nausea and vomiting , seen in 64% of the courses, were the most important nonhematological side effects. Alopecia was almost universal. Hemorrhagic cystitis was observed in only 1 patient. We have concluded that the combination of ifosfamide, mesna, and etoposide is effective in advanced refractory sarcomas, and has acceptable toxicity.