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A southwest oncology group and cancer and leukemia group B phase II study of doxorubicin, dacarbazine, ifosfamide, and mesna in Adults with advanced osteosarcoma, ewing's sarcoma, and rhabdomyosarcoma

  1. Karen Antman M.D.1,
  2. John Crowley Ph.D.2,*,
  3. Stanley P. Balcerzak M.D.3,
  4. Raymond A. Kempf M.D.4,
  5. Raymond B. Weiss M.D.5,
  6. Gerald H. Clamon M.D.6,
  7. Laurence H. Baker D.O.7

Article first published online: 31 OCT 2000

DOI: 10.1002/(SICI)1097-0142(19980401)82:7<1288::AID-CNCR11>3.0.CO;2-2

Issue

Cancer

Cancer

Volume 82, Issue 7, pages 1288–1295, 1 April 1998

Additional Information

How to Cite

Antman, K., Crowley, J., Balcerzak, S. P., Kempf, R. A., Weiss, R. B., Clamon, G. H. and Baker, L. H. (1998), A southwest oncology group and cancer and leukemia group B phase II study of doxorubicin, dacarbazine, ifosfamide, and mesna in Adults with advanced osteosarcoma, ewing's sarcoma, and rhabdomyosarcoma. Cancer, 82: 1288–1295. doi: 10.1002/(SICI)1097-0142(19980401)82:7<1288::AID-CNCR11>3.0.CO;2-2

Author Information

  1. 1

    Division of Medical Oncology, Columbia-Presbyterian Medical Center, New York, New York

  2. 2

    Southwest Oncology Group Statistical Center, Seattle, Washington

  3. 3

    Ohio State University Health Center, Columbus, Ohio

  4. 4

    University of Southern California, Norris Cancer Center, Los Angeles, California

  5. 5

    Walter Reed Army Medical Center, Washington, DC

  6. 6

    University of Iowa, Iowa City, Iowa

  7. 7

    University of Michigan, Ann Arbor, Michigan

*Southwest Oncology Group, Operations Office, 14980 Omicron Drive, San Antonio, TX 78245-3217

Publication History

  1. Issue published online: 31 OCT 2000
  2. Article first published online: 31 OCT 2000
  3. Manuscript Revised: 4 DEC 1997
  4. Manuscript Accepted: 4 DEC 1997
  5. Manuscript Received: 1 APR 1996

Funded by

  • PHS Cooperative Agreement awarded by the National Cancer Institute, DHHS. Grant Numbers: CA38926, CA32102, CA37981, CA45807, CA46368, CA42777, CA35261, CA35090, CA35262, CA35176, CA46136, CA46286, CA27057, CA16385, CA04920, CA46113, CA20319, CA58882, CA58861, CA42028, CA35431

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Keywords:

  • adult;
  • rhabdomyosarcoma;
  • Ewing's sarcoma;
  • osteosarcoma

Chemotherapy using a combination of doxorubicin, dacarbazine, ifosfamide, and mesna is an active regimen in adults with advanced or metastatic Ewing's sarcoma and rhabdomyosarcoma. Approximately 10-20% of patients with rhabdomyosarcoma or Ewing's sarcoma remained disease free at 5 years.

Abstract

BACKGROUND

Ewing's sarcomas, osteosarcomas, and rhabdomyosarcomas are significantly more responsive to chemotherapy than other sarcomas. Adjuvant chemotherapy is used routinely based on data from randomized trials. Although a percentage of children with locally advanced or metastatic tumors remain curable, few data exist regarding the tumor's natural history or response and survival in adults.

METHODS

This Phase II study evaluated doxorubicin, dacarbazine, ifosfamide, and mesna (MAID) in adults with inoperable or metastatic Ewing's sarcoma, rhabdomyosarcoma, or osteosarcoma.

RESULTS

Between 1987-1991, 81 patients were entered; 69 patients were eligible. One patient died of neutropenic infection. Ten patients (14%) responded completely and 34 patients (49%) had a complete or partial response. Response rates were significantly higher for patients with Ewing's sarcoma and rhabdomyosarcoma than for those with osteosarcoma (77%, 64%, and 26%, respectively; P < 0.005). Although there were no significant differences in progression free survival by histology, survival for patients with Ewing's sarcoma was significantly longer than for patients with osteosarcoma (P = 0.004.) At the time of last follow-up, 7 patients (10%) were alive without progression: 3 with Ewing's sarcoma, 1 with osteosarcoma, and 3 with rhabdomyosarcoma.

CONCLUSIONS

MAID chemotherapy is an active regimen in adults with advanced or metastatic Ewing's sarcoma and rhabdomyosarcoma. Although there was no direct comparison with a doxorubicin and cisplatin-based regimen, the response rate and survival in patients with osteosarcoma suggest that doxorubicin and cisplatin-based chemotherapy would remain the accepted initial chemotherapy regimen. For patients with rhabdomyosarcoma and Ewing's sarcoma, 10-20% of patients remained disease free at 5 years. Cancer 1998;82:1288-95. © 1998 American Cancer Society.

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