Response to mesna, doxorubicin, ifosfamide, and dacarbazine in 108 patients with metastatic or unresectable sarcoma and no prior chemotherapy.

• DOI: 10.1200/jco.1989.7.9.1208
• Publication Date: 2017-02-23T18:31:24Z
• Authors: A Elias; L Ryan; A Sulkes; J Collins; J Aisner; K H Antman
• Keywords: Mesna; Dacarbazine; Mucositis; Cardiotoxicity

In this phase II trial, 105 eligible patients with no prior chemotherapy and advanced sarcoma received doxorubicin, ifosfamide, dacarbazine (DTIC) mesna uroprotection (MAID). Starting doses of these drugs were 60, 7,500, 900 mg/m2 divided over 72 hours by continuous infusion, respectively. Mesna was given for 84 to 96 at 2,500 mg/m2/d. Myelosuppression dose limiting, causing the only toxic death (sepsis). Nonhematologic toxicity consisted predominantly anorexia vomiting. Severe mucositis, macroscopic hematuria, renal tubular acidosis, failure, CNS occurred in less than 5% cycles. No cardiotoxicity detected. The overall response rate (10% complete [CR]) 47% (95% confidence intervals, 18% 37% 57%, respectively). Most responses (approximately 70%) observed within two Median times progression 10 9 months, Histologic high tumor grade, lesions 5 cm, 1 year from diagnosis study entry correlated probability response. median survival 16 months. Time entry, performance status, extent disease, but not histologic survival. Following CR, remain disease-free 32 Of 15 additional rendered surgery, 30 18 months further therapy. While most relapses sites involvement, metastases 11 80 high-grade sarcomas, whom seven still responding systematically (three responders). Because its substantial MAID regimen is being compared doxorubicin DTIC alone sarcomas observation adjuvant treatment randomized trials.