Sarcoma SACT 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.

For information on open clinical trials please refer to the Cancer Trials Ireland website here and also to basket trials here.

Sarcoma Chemotherapy Regimens

Regimen Name	Indication
Dacarbazine (1.2 g/m²) Therapy –21 day Regimen	00511a Treatment of metastatic soft tissue sarcoma
DOXOrubicin 75mg/m² Monotherapy Regimen	00500a Treatment of locally advanced unresectable or metastatic soft tissue sarcoma.
eriBULin Monotherapy Regimen	00228b Treatment of adult patients with unresectable liposarcoma who have received prior anthracycline containing therapy (unless unsuitable) for advanced or metastatic disease.
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.
*Gemcitabine and DOCEtaxel Therapy - 21 day** Regimen	00501a Treatment of locally advanced unresectable or metastatic soft tissue sarcoma.
Etoposide and ifosfamide - vinCRIStine, DOXOrubicin and cyclophosphamide (IE-VAC) Therapy – Two Weekly Intervals Regimen	00675a For the treatment of adolescents/young adults with newly diagnosed Ewing Sarcoma/ Ewing Family of tumours 00675b For the treatment of adolescents/young adults with rhabdomyosarcoma or desmoplastic intra-abdominal small round blue cell tumour.
Etoposide and ifosfamide - vinCRIStine, DOXOrubicin and cyclophosphamide (IE-VAC) Therapy – Three Weekly Intervals Regimen	00747a For the treatment of adult patients with newly diagnosed Ewing Sarcoma/ Ewing Family of tumours. 00747b For the treatment of adult patients with rhabdomyosarcoma or desmoplastic intra-abdominal small round blue cell tumour.
Ifosfamide Etoposide (IE) Therapy Regimen	00596a For the treatment of relapsed Ewing Sarcoma. 00596b For the treatment of osteosarcoma
High Dose Ifosfamide Therapy- 21 day Regimen	00680a Recurrent and Primary Refractory Ewing Sarcoma
Irinotecan and Temozolomide Therapy- 21 days Regimen	00504a Treatment of patients with relapsed/refractory Ewing’s sarcoma
Ifosfamide, vinCRIStine, DOXOrubicin, DACTINomycin (IVADo) Therapy Regimen	00754a For the treatment of rhabdomyosarcoma in high / very high risk patients less than 40 years of age.
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
Mifamurtide Regimen	00100a Treatment of high-grade resectable non-metastatic osteosarcoma after macroscopically complete surgical resection, in children, adolescents and young adults.
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.
Pegylated Liposomal DOXOrubicin 50mg/m2 - 28 days Regimen	00205a Monotherapy for patients with metastatic breast cancer. 00205b Treatment of advanced ovarian cancer in women who have failed a first-line platinum-based chemotherapy regimen 00205c Metastatic soft tissue sarcoma
Pegylated Liposomal DOXOrubicin 20mg/m² - 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.
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.
SUNitinib 50mg (21 Days) Therapy Regimen	00719a Treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) in adults after failure of imatinib treatment due toresistance or intolerance.
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.
vinBLAStine and Methotrexate Therapy Regimen	00554a Treatment of advanced aggressive fibromatosis
vinCRIStine, Irinotecan and Temozolomide (VIT) Therapy Regimen	00757a For the treatment of relapsed/refractory rhabdomyosarcoma in adults.

Regimen Name

Indication

Dacarbazine (1.2 g/m²) Therapy –21 day