Purpose. This study investigates the efficacy and toxicity of daily oral etoposide in
chemotherapy for non-heavily pretreated advanced and metastatic soft tissue sarcoma (STS).
Subjects. Twenty-seven patients with progressive and measurable disease were treated. Median age was 53 years
(range 20–71 years) and performance status WHO 0 or 1. Histologies included mainly leiomyosarcoma (8),
malignant fibrous histiocytoma (4), rhabdomyosarcoma (4), liposarcoma (2) and synovial sarcoma (2). Fifteen
patients had received prior radiotherapy, of whom three included sites with haematopoiesis. All patients had received
prior chemotherapy, including adjuvant therapy (7) and mostly consisted of one two-drug schedule (ifosfamide and
doxorubicin) or two single-drug regimens.
Methods. Chemotherapy consisted of etoposide (VP16-213), 50 mg m-2
day-1 × 21 q 4 weeks. Blood cell counts
were done weekly. Dose reductions and a maximum delay of 2 weeks was allowed depending on cell counts during
treatment and at the start of a new 4-week treatment cycle.
Results. No objective response was observed. Progressive disease was observed after two treatment cycles in 17/27
patients (68%) and after three cycles in 22/27 patients (81%). The other patients received three to five cycles.
Twenty-four patients went off study due to progressive disease. Grade 3 and 4 neutropenia was observed in eight
and one patients, respectively. Thrombocytopenia grade 3 was seen in two patients. Non-haematological toxicity
grade 3 (nausea, diarrhoea or alopecia) was observed in three patients, and grade 4 (dyspnea, hypotension or
haemorrhage) in three patients.
Discussion. No objective response was obtained. Oral etoposide at a dose of 50 mg m-2
day-1 × 21 q 4 weeks is
inactive in chemotherapy of pretreated STS. Disease progression occurred within three cycles in the majority (81%)
of patients. Toxicity of this regimen in non-heavily pretreated patients is low.