What are the chemotherapy regimens for the treatment of metastatic soft tissue sarcoma?

Updated: Apr 29, 2019
  • Author: from Memorial Sloan-Kettering - Mrinal M Gounder, MD; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

Answer

Chemotherapy regimens for the treatment of metastatic soft tissue sarcoma include the following:

  • Doxorubicin 60 mg/m2 every 3 wk; doses as high as 75 mg/m2 can be given; however, this can be administered as a split dose over 3 d (25 mg/m2/day for 3 d); maximum lifetime dose is 475-600 mg/m2 or

  • Liposomal pegylated doxorubicin: doses as high as 50 mg/m2 every 4 wk have been used in clinical trials; however, this is associated with significant toxicity; commonly used doses include 30-35 mg/m2 every 4 wk; no maximum lifetime doses or

  • Ifosfamide 2000-3000 mg/m2/day IV over 3 h for 3-4 d plus mesna; repeat every 21 d or

  • Ifosfamide 5000 mg/m2 over 24 h plus  mesna 5000 mg/m2 over 24 h and an additional 400-600 mg/m2 for 2 h after completion of ifosfamide; repeat every 21 d (European schedule) or

  • Gemcitabine 1200 mg/m2 IV over 90-120min on days 1 and 8; repeat cycle every 21d or

  • Trabectedin 1.5 mg/m2 IV q3wk until disease progression or unacceptable toxicity; premedication require and infuse via central line over 24h [16, 17, 18, 19, 20, 21] or

  • Epirubicin 160 mg/m2 IV bolus every 3 wk with growth factor support [22] or

  • Dacarbazine 250 mg/m2 IV for 5 d or 800-1000 mg/m2 IV every 3 wk or

  • Pazopanib 800 mg PO qd (not indicated for liposarcoma outside of a clinical trial; FDA approved as second-line chemotherapy; recommend starting at a low dose of 200 mg for 2 weeks and slowly increasing the dose)


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