Randomized Phase II Study of Brostallicin (PNU-166196A) Versus Doxorubicin as First Line Chemotherapy in Patients With Advanced or Metastatic Soft Tissue Sarcoma
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed high- or intermediate-grade malignant soft
tissue sarcoma* of 1 of the following cellular types:
- Adipocytic (e.g., liposarcoma dedifferentiated, myxoid/round cell, pleomorphic,
mixed-type, not otherwise specified)
- Fibroblastic (e.g., adult fibrosarcoma, myxofibrosarcoma, or sclerosing
epithelioid fibrosarcoma)
- So-called fibrohistiocytic (e.g., pleomorphic malignant fibrous histiocytoma
[MFH], giant cell MFH, or inflammatory MFH)
- Leiomyosarcoma
- Malignant glomus tumors
- Skeletal muscle (e.g., rhabdomyosarcoma, alveolar, or pleomorphic)
- Vascular (e.g., epithelioid hemangioendothelioma or angiosarcoma)
- Uncertain differentiation (e.g., synovial, epithelioid, alveolar soft part,
clear cell, desmoplastic small round cell, extra-renal rhabdoid, malignant
mesenchymoma, perivascular epithelioid cell tumor [PEComa], or intimal sarcoma)
- Malignant peripheral nerve sheath tumors
- Malignant solitary fibrous tumors
- Undifferentiated soft tissue sarcomas not otherwise specified
- Other types of sarcoma if approved by the study coordinator NOTE: *Includes
malignant tumors of non-organ origin and skin and uterine leiomyosarcoma
- The following tumor types are excluded:
- Embryonal rhabdomyosarcoma
- Chondrosarcoma
- Osteosarcoma
- Ewing tumors/primitive neuroectodermal tumor (PNET)
- Gastrointestinal stromal tumors
- Dermatofibrosarcoma protuberans
- Inflammatory myofibroblastic sarcoma
- Neuroblastoma
- Malignant mesothelioma
- Mixed mesodermal tumors of the uterus
- Relapsed, refractory, and/or metastatic disease incurable by surgery or radiotherapy
- Measurable disease
- Must have formalin fixed paraffin-embedded tumor blocks and representative
hematoxylin/eosin slides available for histological central review
- No symptomatic or known CNS metastases
PATIENT CHARACTERISTICS:
- At least 60 years of age OR ≥ 18 years of age if patient is not suitable for
intensive combination chemotherapy treatments
- WHO performance status 0-1
- Absolute neutrophil count > 2,000/mm³
- Platelet count > 100,000/mm³
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN
- Alkaline phosphatase ≤ 2.5 times ULN
- Creatinine clearance ≥ 60 mL/min
- No serious cardiac illness within the past 6 months, including, but not limited to
the following:
- History of documented congestive heart failure
- High-risk uncontrolled arrhythmias
- Angina pectoris requiring antianginal medication
- Clinically significant valvular heart disease
- Evidence of transmural infarction on ECG
- Poorly-controlled hypertension (e.g., systolic blood pressure [BP] > 180 mm Hg
or diastolic BP > 100 mm Hg)
- Normal 12-lead ECG
- LVEF normal by MUGA or echocardiogram
- No other malignancy within the past 3 years except adequately treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix or breast
- No other serious and/or unstable medical condition, illness, or lab abnormality that
would preclude study participation
- No psychiatric illness or familial, social, or geographical condition that would
preclude study compliance
- No active uncontrolled infection
- No known AIDS positivity
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
- No prior chemotherapy regimen for advanced or metastatic disease (neoadjuvant and
adjuvant therapy allowed)
- No concurrent sargramostim (GM-CSF) except in cases of febrile neutropenia
- No other concurrent anticancer therapy or investigational agents, including any of
the following:
- Chemotherapy
- Biological response modifiers
- Hormone therapy
- Immunotherapy
- No other concurrent clinical treatment trial participation