EORTC 62012: doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced soft tissue sarcoma
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.
Overview
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.
- 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.
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.
- Excluded some histologies; benefit may differ by subtype (for example synovial sarcoma is ifosfamide-sensitive).
Similar pages
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