Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov 22;4(1):16.
doi: 10.1186/2045-3329-4-16. eCollection 2014.

High-dose continuous-infusion ifosfamide in advanced well-differentiated/dedifferentiated liposarcoma

Roberta Sanfilippo  1 , Rossella Bertulli  1 , Andrea Marrari  1 , Elena Fumagalli  1 , Silvana Pilotti  2 , Carlo Morosi  3 , Antonella Messina  3 , Angelo Paolo Dei Tos  4 , Alessandro Gronchi  5 , Paolo Giovanni Casali  1
Affiliations

High-dose continuous-infusion ifosfamide in advanced well-differentiated/dedifferentiated liposarcoma

Roberta Sanfilippo et al. Clin Sarcoma Res. .

Abstract

Background: Liposarcomas represent the most common histological type of soft-tissue sarcomas (STS). Its main subgroups, WD/DD, is known to be poorly sensitive to chemotherapy, with few active agents, i.e., anthracyclines +/- ifosfamide and trabectedin. High-dose ifosfamide (HDIFX >12 g/m2) is active in STS pts pretreated with standard-dose IFX, though with greater toxicity. A prolonged continuous-infusion (ci) through a portable external pump may be an alternative way to administer HDIFX.

Methods: From March 2002 to August 2013, 28 pts (median age =60, range =37-73 yrs) with advanced disease (6 WD and 22 WD/DD) were given ciHDIFX, at the dose of 14 g/m2 as a 14-day continuous infusion every 4 weeks. Twenty-four pts (86%) were previously treated with chemotherapy (19 with anthracyclines and ifosfamide; 4 with anthracycline monotherapy; 1 with trabectedin).

Results: Seven PR (all in DDLPS), 2 minor response (MR) and 11 SD were observed. Of interest, 6 of 9 patients with PR or MR had had SD with the previous therapy with anthracycline plus ifosfamide. The median progression-free survival was 7 months. Most common side effects were mild myelosuppression (anemia G2-3 in 3 pts; G2-3 neutropenia in 3 pts and G4 in 1; G3 thrombocytopenia in 1 pt); nausea (G3 in 3 pts) and fatigue (G3 in 6 pts). One pts had transient G3 confusion.

Conclusions: These data suggest that ciHDIFX is active in WD/DDLPS, even in patients already treated with a combination of anthracyclines plus ifosfamide. In this series, ciHDIFX regimen was better tolerated than HDIFX in published studies.

Keywords: Chemotherapy; Ifosfamide; Liposarcoma; Soft tissue sarcoma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
RECIST partial response in a DDLP.
Figure 2
Figure 2
Dimensional response of the de-differentiated component, while the well differentiated portion stable.
Figure 3
Figure 3
Progression free survival (PFS).
Figure 4
Figure 4
Progression free survival (PFS) of WDLPS.
Figure 5
Figure 5
Progression free survival (PFS) of DDLPS.
See this image and copyright information in PMC

References

    1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO Classification of Tumours of Bone and Soft Tissue. Lyon: IARC; 2013. pp. 33–36.
    1. Dei Tos AP, Pedetour F. Well-differentiated liposarcoma. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO Classification of Soft Tissue Tumor and Bone. Lyon: IARC; 2013. pp. 33–36.
    1. Dei Tos AP, Marino-Enriquez A, Pedetour F, Rossi S. Dedifferentiated liposarcoma. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO Classification of Soft Tissue Tumor and Bone. IARC: Lyon; 2013. pp. 37–38.
    1. Mussi C, Collini P, Miceli R, Barisella M, Mariani L, Fiore M, Casali PG, Gronchi A. The prognostic impact of dedifferentiation in retroperitoneal liposarcoma: a series of surgically treated patients at a single institution. Cancer. 2008;113:1657–1665. doi: 10.1002/cncr.23774. - DOI - PubMed
    1. Binh MB, Sastre-Garau X, Guillou L, de Pinieux G, Terrier P, Lagacé R, Aurias A, Hostein I, Coindre JM. MDM2 and CDK4 immunostainings are useful adjuncts in diagnosing well-differentiated and dedifferentiated liposarcoma subtypes: a comparative analysis of 559 soft tissue neoplasms with genetic data. Am J Surg Pathol. 2005;29:1340–1347. doi: 10.1097/01.pas.0000170343.09562.39. - DOI - PubMed