Ifosfamide-based Combination Chemotherapy in Advanced Soft-Tissue Sarcoma: A Practice Guideline
Author Information
Author(s): Verma S. MD, Younus J. MD, Stys–Norman D., Haynes A.E BSc, Blackstein M. MD
Primary Institution: Cancer Care Ontario
Hypothesis
Do combination chemotherapy regimens containing ifosfamide have an advantage in terms of response rate, time to progression, or survival compared with similar regimens without ifosfamide when used as first-line therapy?
Conclusion
The addition of ifosfamide to standard first-line doxorubicin-containing regimens is not recommended over single-agent doxorubicin.
Supporting Evidence
- The prognosis for patients with inoperable or metastatic soft-tissue sarcoma remains grim.
- Ifosfamide has documented activity in patients who have received prior treatment with doxorubicin.
- Combination chemotherapy using appropriate doses of ifosfamide and doxorubicin may represent the most effective systemic treatment in this population.
- External feedback from Ontario practitioners was incorporated into the report.
Takeaway
Doctors looked at how well ifosfamide works with other medicines for treating a type of cancer called soft-tissue sarcoma, and found it doesn't help patients live longer.
Methodology
A systematic review and meta-analysis served as the evidentiary base for this clinical practice guideline.
Potential Biases
No conflicts of interest were declared by the members of the Sarcoma Disease Site Group.
Limitations
The results of some phase II trials were non-contributory to the final guideline recommendations.
Participant Demographics
Adult patients with inoperable locally advanced or metastatic soft-tissue sarcoma.
Statistical Information
P-Value
p = 0.03 and p < 0.005
Statistical Significance
p<0.05
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