Int J Clin Oncol. 2005 Dec;10(6):438-40.
A new therapeutic approach in patients with advanced sarcoma.
Kasper B, Ho AD, Egerer G.
University of Heidelberg, Department of Internal Medicine V, Im
Neuenheimer Feld 410, D-69120 Heidelberg, Germany.
Bernd.Kasper@med.uni-heidelberg.de
Sarcomas represent a rare and heterogeneous disease and the prognosis
of patients remains poor, with a disease-free survival at 5 years of
less than 10%. Only a few chemotherapeutic agents, such as doxorubicin
and ifosfamide, have been identified to be active with response rates
above 20%. The concept of angiostatic therapy in combination with
proapoptotic biomodulators and chemotherapeutics has not been evaluated
in these patients. Therefore, the efficacy of low-dose trofosfamide in
combination with the peroxisome proliferator-activated
receptor-gamma-agonist, pioglitazone, and the selective
cyclooxygenase-2 inhibitor, rofecoxib, was evaluated in a pilot study.
Six patients with advanced sarcoma received a combination of oral
pioglitazone plus rofecoxib and, after 14 days, oral trofosfamide. The
therapy was administered continuously daily. Four patients received the
triple combination as maintenance therapy; three of them achieved
stabilization of disease. Two patients received the combination as
relapse therapy; however, it failed to stop disease progression. Side
effects were generally mild and hospitalization was not necessary. This
new triple combination of low-dose trofosfamide, pioglitazone, and
rofecoxib may represent a feasible new alternative in the palliative
treatment of sarcoma patients.
PMID: 16369750 [PubMed – in process]