12/18/2018 Treatment protocols for soft tissue and bone sarcoma - UpToDate

Authors: Tim Brenner, PharmD, BCOP, Shrina Duggal, PharmD, BCOP, Jim Natale, PharmD, BCOP
Section Editor: Robert Maki, MD, PhD
Deputy Editor: Diane MF Savarese, MD

Contributor Disclosures

All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Nov 2018. | This topic last updated: Dec 12, 2018.

INTRODUCTION — The following material represents a subset of chemotherapy 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 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 "Systemic 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 regimens must be administered by clinicians who are trained in the use of
chemotherapy. 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)

Olaratumab and doxorubicin for soft-tissue sarcoma — (table 7)

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12/18/2018 Treatment protocols for soft tissue and bone sarcoma - UpToDate

Pegylated liposomal doxorubicin — (table 8)

Trabectedin regimen for unresectable or metastatic liposarcoma or leiomyosarcoma — (table 9)

Weekly paclitaxel for angiosarcoma — (table 10)

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

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