A comparison of adriamycin versus vincristine and adriamycin, and cyclophosphamide versus vincristine, actinomycin-D, and cyclophosphamide for advanced sarcoma

Abstract

This randomized study, conducted by the Eastern Cooperative Oncology Group, compared Adriamycin (doxorubicin) (70 mg/m²) versus vincristine (1.4 mg/m²) and Adriamycin (50 mg/m²); and cyclophosphamide (750 mg/m²) versus vincristine (1.4 mg/m²), actinomycin-D, (0.4 mg/m²), and cyclophosphamide (750 mg/m²) for treatment of metastatic mesenchymal malignancies. The respective response rate seen in 200 evaluable patients to the treatments were, 27, 19, and 11%. The response rate to Adriamycin was significantly better than the response to vincristine, actinomycin-D, and cyclophosphamide (P = 0.03, two-sided). The respective median survivals on the three treatments were 37, 34, and 41 weeks and were not significantly different. Moderate or severe vomiting occurred in 60% of patients receiving vincristine—cyclophosphamide—adriamycin, a greater frequency than in Adriamycin alone (P = .09 two-sided). Severe or life-threatening hematologic toxicity (leukocytes P = 0.07, P = 0.02, two-sided). This trial establishes that Adriamycin has a better response rate than the combination of vincristine—actinomycin-D—cyclophosphamide in advanced sarcomas. The combination of vincristine, Adriamycin, and cyclophosphamide increased toxicity and did not add to the therapeutic effect achieved with Adriamycin alone.