Platinum and etoposide as second-line chemotherapy in advanced adult soft tissue sarcomas

Abstract

9063 Background: Advanced soft tissue sarcomas (STS) relapsing after first line chemotherapy are incurable. There is no standard treatment for patients (pts) relapsing after Doxorubicin and Ifosfamide first line chemotherapy, which are the most active drugs. Methods: 17 adults STS pts, relapsing after first line chemotherapy including Doxorubicin and Ifosfamide (mainly VAIA regimen) were treated with Platinum and Etoposide at our institution and retrospectively analysed. Median age was 40 (20–67) years. Histology were: leiomiosarcoma (3 pts), Ewing/PNET (7 pts), rabdomiosarcoma (4 pts), sinovialsarcoma (2 pts) and schwannoma (1 pt). Five pts had extremity lesions while 12 had trunk disease. At diagnosis 15 pts had advanced disease, one had microscopic residual and one was NED after surgery. Results: After first line chemotherapy, 2 pts achieved a complete remission, 4 a partial response, 2 were stable, 7 progressed and 2 were not evaluable; median time to relapse was 2 (0–21) months. Six and 10 pts had local and distant relapse, respectively. A median of 3 cycles (1–8) of Platinum and Etoposide were given. Toxicities were: 12% neutropenia G3, 12% trombocytopenia G4, 6% renal toxicity G2; one patient suffered from subarachnoid hemorrhage. We obtained 2 partial response (both rabdomiosarcoma, with overall survival of 3 and 15 months respectively), 3 stable disease, 9 progression disease and 3 not evaluable. Median time to progression was 2 (0–15) months. Conclusions: in STS pts relapsing after doxorubicin-ifosfamide regimen, Platinum and Etoposide as second line chemotherapy was a safe treatment permitting some responses (11%); Rabdomiosarcoma seemed to be the most responsive histology. No significant financial relationships to disclose.