Chemotherapy of sarcomas with a combination of adriamycin and dimethyl triazeno imidazole carboxamide

Abstract

During the initial therapeutic evaluations of adriamycin and DIC, efficacy was noted with each in the treatment of advanced sarcomas. Preclinical studies suggested possible synergism without additive toxicity. This lead to our evaluating the two agents in combination in metastatic sarcomas. Adriamycin at 60 mg/m2 was given I.V. on day 1 and DIC 250 mg/m2 I.V. on days 1 to 5, with the entire regimen repeated every 21 days. The dosage of both drugs was reduced 25% in patients with extensive prior therapy. Of 120 patients entered, 100 were evaluable for therapeutic efficacy. Five complete and 36 partial remissions (> 50%) were observed for a response rate of 41% including the following diagnoses: synovial cell sarcoma 2/2; rhabdomyosarcoma 3/5; undifferentiated sarcoma 6/13; fibrosarcoma 5/11; osteogenic sarcoma 8/18; liposarcoma 3/7; mesothelioma 3/7; neurofibrosarcoma 4/10; leiomyosarcoma 6/16; angiosarcoma 1/5; chondrosarcoma 0/4, and miscellaneous sarcomas 0/2. The median duration for complete remission was 5+ months (range—3+ to 7+ months) and for partial remission was 31/2+ months (1–10+ months) with 29/41 still in remission. Toxicity was limited predominantly to vomiting, alopecia, and myelosuppression. Leukocyte depression was maximum by median day 15, with prompt recovery permitting retreatment at a 3-week interval in all but 8% of courses. Combination therapy with adriamycin and DIC appears to be an effective and promising regimen in the treatment of metastatic sarcomas.