Feasibility and Toxicity of Interval-Compressed Chemotherapy in Asian Children and Young Adults with Sarcoma

SIMPLE SUMMARY: Interval-compressed chemotherapy was evaluated in Asian children and young adults with sarcomas to assess the feasibility of this treatment strategy. Ultimately, the goal is to improve survival in this group of individuals with high-risk malignancies without increasing short-term or long-term toxicities. The feasibility of this strategy in Asian patients with sarcomas needed to be established prior to evaluating the efficacy of this approach in a prospective trial. ABSTRACT: Twelve Asian patients with sarcoma received interval-compressed (ic-) chemotherapy scheduled every 14 days with a regimen of vincristine (2 mg/m(2)), doxorubicin (75 mg/m(2)), and cyclophosphamide (1200–2200 mg/m(2)) (VDC) alternating with a regimen of ifosfamide (9000 mg/m(2)) and etoposide (500 mg/m(2)) (IE), with filgrastim (5–10 mcg/kg/day) between cycles. Carboplatin (800 mg/m(2)) was added for CIC-rearranged sarcoma. The patients were treated with 129 cycles of ic-VDC/IE with a median interval of 19 days (interquartile range [IQR], 15–24 days. Median nadirs (IQR) were neutrophil count, 134 (30–396) × 10(6)/L at day 11 (10–12), recovery by day 15 (14–17) and platelet count, 35 (23–83) × 10(9)/L at day 11 (10–13), recovery by day 17 (14–21). Fever and bacteremia were observed in 36% and 8% of cycles, respectively. The diagnoses were Ewing sarcoma (6), rhabdomyosarcoma (3), myoepithelial carcinoma (1), malignant peripheral nerve sheath tumor (1), and CIC-DUX4 Sarcoma (1). Seven of the nine patients with measurable tumors responded (one CR and six PR). Interval-compressed chemotherapy is feasible in the treatment of Asian children and young adults with sarcomas.