Sarcoma Chemotherapy Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option. In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to HSE’s terms of use.

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie.

Sarcoma Chemotherapy Regimens

Regimen Name	Indication
DOXOrubicin (25mg/m2/day and CISplatin (100mg/m2) Therapy-21 day cycle Regimen	00420a Neoadjuvant/Adjuvant therapy of osteosarcoma.
DOXOrubicin (60) and Ifosfamide Therapy Regimen	00391a Treatment of locally advanced unresectable or metastatic soft tissue sarcomas.
DOXOrubicin (75) and Ifosfamide Therapy Regimen	00392a Neoadjuvant treatment of high risk soft tissue sarcoma. 00392b Treatment of locally advanced unresectable or metastatic soft tissue sarcomas.
Imatinib Therapy-GIST Regimen	00335a Treatment of adult patients with Kit (CD117) positive unresectable and/or metastatic malignant gastrointestinal stromal tumours (GIST). 00335b Adjuvant treatment of adult patients who are at significant risk of relapse following resection of Kit (CD117)-positive GIST.
(MAP) Methotrexate (12000mg/m2) DOXOrubicin (37.5mg/m2/day) and CISplatin (60mg/m2) Therapy Regimen	00463a Neoadjuvant/Adjuvant therapy of localised or metastatic high grade osteosarcoma of an extremity/axial skeleton (excluding craniofacial sites) -all disease sites amenable to complete surgical resection
Pegylated Liposomal DOXOrubicin 20mg/m2 (CAELYX®) 21 days Regimen	00462a Treatment of AIDS-related Kaposi’s sarcoma (KS) in patients with low CD4 counts ( < 200 CD4 lymphocytes/mm3) and extensive mucocutaneous or visceral disease.
Mifamurtide Regimen	00100a Treatment of high-grade resectable non-metastatic osteosarcoma after macroscopically complete surgical resection, in children, adolescents and young adults.
Regorafenib Monotherapy Regimen	00244b Treatment of adult patients with unresectable or metastatic gastrointestinal stromal tumours (GIST) who progressed on or are intolerant to prior treatment with imatinib and sunitinib.
SUNItinib 50mg Therapy Regimen	00325a Treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) in adults after failure of imatinib treatment due to resistance or intolerance.
PAZOPanib Therapy Regimen	00445b Treatment of adult patients with selective subtypes of advanced Soft Tissue Sarcoma (STS) who have received prior chemotherapy for metastatic disease or who have progressed within 12 months after (neo) adjuvant therapy.
Trabectedin Monotherapy Regimen	00374a Treatment of adult patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents.

Regimen Name

Indication

DOXOrubicin (25mg/m2/day and CISplatin (100mg/m2) Therapy-21 day cycle

Regimen

00420a

Neoadjuvant/Adjuvant therapy of osteosarcoma.

DOXOrubicin (60) and Ifosfamide Therapy

Regimen

00391a

Treatment of locally advanced unresectable or metastatic soft tissue sarcomas.

DOXOrubicin (75) and Ifosfamide Therapy

Regimen

00392a

Neoadjuvant treatment of high risk soft tissue sarcoma.

00392b

Treatment of locally advanced unresectable or metastatic soft tissue sarcomas.

Imatinib Therapy-GIST

Regimen

00335a

Treatment of adult patients with Kit (CD117) positive unresectable and/or metastatic malignant gastrointestinal stromal tumours (GIST).

00335b

Adjuvant treatment of adult patients who are at significant risk of relapse following resection of Kit (CD117)-positive GIST.

(MAP) Methotrexate (12000mg/m2) DOXOrubicin (37.5mg/m2/day) and CISplatin (60mg/m2) Therapy

Regimen

00463a

Neoadjuvant/Adjuvant therapy of localised or metastatic high grade osteosarcoma of an extremity/axial skeleton (excluding craniofacial sites) -all disease sites amenable to complete surgical resection

Pegylated Liposomal DOXOrubicin 20mg/m2 (CAELYX®) 21 days

Regimen

00462a

Treatment of AIDS-related Kaposi’s sarcoma (KS) in patients with low CD4 counts ( < 200 CD4 lymphocytes/mm3) and extensive mucocutaneous or visceral disease.

Mifamurtide

Regimen

00100a

Treatment of high-grade resectable non-metastatic osteosarcoma after macroscopically complete surgical resection, in children, adolescents and young adults.

Regorafenib Monotherapy

Regimen

00244b

Treatment of adult patients with unresectable or metastatic gastrointestinal stromal tumours (GIST) who progressed on or are intolerant to prior treatment with imatinib and sunitinib.

SUNItinib 50mg Therapy

Regimen

00325a

Treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) in adults after failure of imatinib treatment due to resistance or intolerance.

PAZOPanib Therapy

Regimen

00445b

Treatment of adult patients with selective subtypes of advanced Soft Tissue Sarcoma (STS) who have received prior chemotherapy for metastatic disease or who have progressed within 12 months after (neo) adjuvant therapy.

Trabectedin Monotherapy

Regimen

00374a

Treatment of adult patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents.