A retrospective study on combination therapy with ifosfamide, adriamycin and cisplatin for progressive or recurrent uterine sarcoma

Abstract

Abstract. There is currently insufficient evidence to recommend a specific chemotherapeutic regimen as standard treatment for uterine sarcomas. In this study, we investigated the toxicity and effectiveness of ifosfamide, adriamycin and cisplatin (IAP therapy) in patients with progressive and recurrent uterine sarcoma. A total of 11 patients with progressive or recurrent uterine sarcoma containing leiomyosarcoma (LMS), undifferentiated endometrial sarcoma (UES) or adenosarcoma, who were diagnosed at our institution, were retrospectively investigated. We recorded the adverse events, response rate and progression-free survival in these cases. The histological types included LMS (54.5%), adenosarcoma (27.3%) and UES (18.2%). Grade ≥3 leukopenia or neutropenia were observed in all the cases, febrile neutropenia developed in 45.5% of the patients and grade 4 thrombocytopenia developed in 3 cases (27.3%). With IAP therapy, the response rate was 36.4% and the disease control rate was 90.9%. Therefore, IAP therapy may be a viable option as chemotherapy for uterine sarcoma.

Restoring microenvironmental redox and pH homeostasis inhibits neoplastic cell growth and migration: therapeutic efficacy of esomeprazole plus sulfasalazine on 3-MCA-induced sarcoma

“…Cisplatin is used in many tumors, including melanoma [ 43 ], and is one of the drug of choice for sarcoma [ 44 ]. However, even in combination with other chemotherapeutics, cisplatin is often unable to eliminate the tumor; moreover, it causes severe side effects [ 45 , 46 ].…”

“…Both esomeprazole and sulfasalazine have been reported to sensitize cells to cisplatin [ 13 , 18 , 35 – 39 , 50 ], that is a first line drug for many human tumors, including sarcoma [ 44 ]. Our data show that the combination of esomeprazole and sCPG is equally or more efficient in inhibiting tumor cell growth than the association of esomeprazole or sCPG with cisplatin.…”

“…Our data show that the combination of esomeprazole and sCPG is equally or more efficient in inhibiting tumor cell growth than the association of esomeprazole or sCPG with cisplatin. Thus, the combined therapy we propose in this study is advantageous over the use of each inhibitor with chemotherapeutics, since, unlike classical anti-tumor drugs, esomeprazole and sulfasalazine do not display toxic effects that may be highly invalidating for the patient [ 44 , 45 ].…”

A Single-Centre Experience on the Management of Adenosarcoma: A Successful Report of an Integrated Medical and Surgical Approach

“…In fact, the role of medical treatment for patients with advanced or recurrent disease is still undefined and only supported by limited reports. 6,[14][15][16][17][18][19][20] Currently, given the extreme rarity of this of this subtype of sarcoma, specific clinical guidelines are lacking, and the management of adenosarcoma does not differ from that of all other gynaecologic sarcomas. 24 We are aware that our case series is too limited to provide a definitive suggestion on adenosarcoma clinical management.…”

“…1 Likewise, the role of chemotherapy in this disease, supported by only small retrospective series and case reports, is still not well defined, and its place in an integrative approach to surgical cytoreduction is still questioned. 6,[14][15][16][17][18][19][20] We report here a case series of adenosarcoma referred to our institution from 2009, focusing on surgical and medical treatment, pathologic features, and outcome.…”