Cyclophosphamide, vincristine, adriamycin, and DTIC (CYVADIC) combination chemotherapy for the treatment of advanced sarcomas.

TLDR

A regimen of cyclophosphamide, vincristine, Adriamycin, and DTIC (CYVADIC) was administered to 140 adults with advanced sarcomas (125 soft‑tissue and 15 bone). In 140 patients, CYVADIC achieved a 47 % overall response rate (21 complete, 45 partial), with soft‑tissue sarcomas responding at 50 % versus 20 % in bone sarcomas; median response duration was 9.5 months for complete and 7 months for partial responders, median time to response 9 weeks over three courses, and responders survived a median of 16 months versus 7 months for nonresponders, while toxicity was mainly myelosuppression, vomiting, fever, and neuropathy.

Abstract

One hundred and forty adult patients with advanced sarcomas (125 soft tissue and 15 bone) were treated with a combination chemotherapy regimen consisting of cyclophosphamide, vincristine, Adriamycin, and DTIC (CYVADIC). There were 21 (15%) complete and 45 (32%) partial responders, with an overall response rate of 47%. The response rate was 50% (17% complete) for patients with soft tissue sarcomas compared with 20% (none complete) for patients with bone sarcomas. The median duration of response was 9.5 months (range, 1-40+ months) for complete responders and 7 months (range, 1-31 months) for partial responders. The median time to achieve response was 9 weeks and the median number of courses of therapy to response was three. The median survival time was 16 months for responders compared with 7 months for nonresponders (P = 0.001). The most responsive tumor types were neurofibrosarcoma, rhabdomyosarcoma, leiomyosarcoma, fibrosarcoma, and angiosarcoma. Pulmonary and soft tissue metastases were more responsive than bone and liver metastases. CYVADIC toxicity was predominantly limited to myelosuppression, vomiting, fever of unknown origin, and neuropathy. CYVADIC is an effective combination chemotherapy regimen in the treatment of advanced sarcomas.