# EORTC 62012: doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced soft tissue sarcoma

Source: https://onco.cc/key-papers/paper-eortc-62012-doxorubicin-ifosfamide-judson-lancet-oncol-2014/  
OnCo record `paper-eortc-62012-doxorubicin-ifosfamide-judson-lancet-oncol-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2014
- DOI: 10.1016/S1470-2045(14)70063-4
- Authors: Judson I, Verweij J, Gelderblom H, et al.
- Findings: Median overall survival 14.3 vs 12.8 months (not significant).; Objective response 26 percent vs 14 percent; median progression-free survival 7.4 vs 4.6 months.
- What it means: 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.
- Caveats: Excluded some histologies; benefit may differ by subtype (for example synovial sarcoma is ifosfamide-sensitive).

## Sources

- Lancet Oncol 2014: https://doi.org/10.1016/S1470-2045(14)70063-4
- PubMed: https://pubmed.ncbi.nlm.nih.gov/24618336/

## Connected records

- cancers: [Leiomyosarcoma](https://onco.cc/cancers/leiomyosarcoma/), [Malignant peripheral nerve sheath tumour (MPNST)](https://onco.cc/cancers/malignant-peripheral-nerve-sheath-tumour/), [Myxofibrosarcoma](https://onco.cc/cancers/myxofibrosarcoma/), [Soft tissue sarcoma of the extremity (localised and advanced)](https://onco.cc/cancers/extremity-soft-tissue-sarcoma/), [Synovial sarcoma](https://onco.cc/cancers/synovial-sarcoma/), [Undifferentiated pleomorphic sarcoma (UPS)](https://onco.cc/cancers/undifferentiated-pleomorphic-sarcoma/)
- drugs: [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Ifosfamide](https://onco.cc/drugs/ifosfamide/)
- trials: [EORTC 62012](https://onco.cc/trials/eortc-62012/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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