27 P - Second line chemotherapy with modulation of drug resistance in patients with advanced soft tissue sarcoma

Abstract

Metastatic soft tissue sarcoma constitutes a major therapeutic problem potentiated by the development of drug resistance. The present pilot study was therefore undertaken in order to study the possibility of modulation of drug resistance by tamoxifen in patients with metastatic soft tissue sarcoma after the administration of combined cytostatic therapy consisting of ifosphamide (1.5 g/m2), adriblastin (50 mg/m2) and DTIC (200/m2), all on days 1-4; (IFADIC).
12 patients with soft tissue sarcoma who experienced progression under or following treatment with IFADIC underwent second-line chemotherapy with Epirubicine 60 mg/m2 (days 1 and 22). CCNU 80 mg/m2 (day 1) (ECC) and high-dose Tamoxifen (480 mg/day. day -1 to +1) in an endeavour to modulate drug resistance. Under this very well tolerated, low toxic regimen. I patient with lung metastases experienced complete remission (duration: 5 months +) and 1 patient partial remission (duration: 6 months). 1 final patient experienced stable disease for 12 months thus resulting in an overall response rate of 3 out of 12 patients. We conclude that this low-toxicity regimen might be effective in heavily pretreated patients with soft tissue sarcoma thus making the use of high-dose tamoxifen a possible canditate for modulation of drug resistance in metastatic soft tissue sarcoma.