Treatment protocols for soft tissue and bone sarcoma

INTRODUCTION — The following material represents a subset of chemotherapy and immunotherapy regimens that are used for the treatment of adult patients with soft tissue and bone sarcomas. This is not an exhaustive list; it includes regimens that are considered by the authors and editors to be commonly used and important for the care of patients with sarcomas. Additional regimens may be added over time, particularly as treatment for bone and soft tissue sarcoma evolves.

This topic review is intended to provide only a listing of chemotherapy and immunotherapy regimens. It does not address the appropriate context for use of these regimens in the care of patients with sarcomas. Clinicians should refer to the individual disease-oriented topic reviews that discuss the use of these protocols in appropriate clinical situations:

●(See "Treatment of locally recurrent and unresectable, locally advanced soft tissue sarcoma of the extremities".)

●(See "Overview of the initial treatment of metastatic soft tissue sarcoma".)

●(See "Adjuvant and neoadjuvant chemotherapy for soft tissue sarcoma of the extremities".)

●(See "Chemotherapy and radiation therapy in the management of osteosarcoma".)

These tables are provided as examples of how to administer these regimens; there may be other acceptable methods. All chemotherapy and immunotherapy regimens must be administered by clinicians who are trained in the use of chemotherapy and immunotherapy. The clinician is expected to use his or her independent medical judgment in the context of individual circumstances to make adjustments, as necessary.

REGIMENS

Bone sarcomas

Doxorubicin plus cisplatin —  (table 1)

Methotrexate plus doxorubicin and cisplatin (MAP) —  (table 2)

Soft tissue sarcomas

Doxorubicin (Adriamycin) plus ifosfamide and mesna (AIM 60/6) —  (table 3)

Doxorubicin (Adriamycin) plus ifosfamide and mesna (AIM 75/9) —  (table 4)

Doxorubicin (Adriamycin) plus ifosfamide and mesna (AIM 75/10) —  (table 5)

Gemcitabine plus docetaxel —  (table 6)

Pegylated liposomal doxorubicin —  (table 7)

Trabectedin regimen for unresectable or metastatic liposarcoma or leiomyosarcoma —  (table 8)

Weekly paclitaxel for angiosarcoma —  (table 9)

ACKNOWLEDGMENT — The UpToDate editorial staff acknowledges Scott M Wirth, PharmD, BCOP, who contributed to an earlier version of this topic review.