Ye Ting, Fan Li, Cao Rubo, Peng Ling, Chen Jing
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Hubei Key Laboratory of Precision Radiation Oncology, Wuhan, 430022, People's Republic of China.
Drug Des Devel Ther. 2025 Aug 7;19:6817-6827. doi: 10.2147/DDDT.S529231. eCollection 2025.
This study aimed to determine the maximum tolerated dose (MTD) of pegylated liposomal doxorubicin (PLD) combined with both ifosfamide (IFO) and supported by human granulocyte colony-stimulating factor (rhG-CSF) for treating advanced soft tissue sarcoma (STS).
Twenty-three patients were enrolled in this trial with 3+3 dose-escalation from January 2020 to September 2022. PLD was initiated at 30 mg/m and incrementally escalated by 5 mg/m per step. MTD was the primary endpoint, and the safety profile served as the secondary endpoint.
Two patients treated with PLD (55 mg/m) experienced dose-limiting toxicities. Ultimately, the MTD of PLD was established as 50 mg/m (single cycle) in combination of IFO (3 g/m/day for days 1-3) and supported by rhG-CSF. Across all dose levels, common grade 3/4 adverse events included leukopenia (86.96%), neutropenia (82.61%), and lymphopenia (56.52%). Twelve of the 23 patients voluntarily chose to continue treatment with this regimen. The overall response rate was 33.33% (95% confidence interval: 9.92-65.11), and the disease control rate was 83.33% (95% confidence interval: 51.59-97.91).
This study successfully determined the MTD of PLD in combination with IFO and rhG-CSF for advanced STS, offering a potentially valuable treatment option with a tolerable safety profile.
本研究旨在确定聚乙二醇化脂质体阿霉素(PLD)联合异环磷酰胺(IFO)并辅以人粒细胞集落刺激因子(rhG-CSF)治疗晚期软组织肉瘤(STS)的最大耐受剂量(MTD)。
2020年1月至2022年9月,23例患者入组该试验,采用3+3剂量递增法。PLD起始剂量为30mg/m²,每步递增5mg/m²。MTD为主要终点,安全性为次要终点。
2例接受PLD(55mg/m²)治疗的患者出现剂量限制性毒性。最终,确定PLD联合IFO(第1-3天3g/m²/天)并辅以rhG-CSF时的MTD为50mg/m²(单周期)。在所有剂量水平中,常见的3/4级不良事件包括白细胞减少(86.96%)、中性粒细胞减少(82.61%)和淋巴细胞减少(56.52%)。23例患者中有12例自愿选择继续使用该方案治疗。总缓解率为33.33%(95%置信区间:9.92-65.11),疾病控制率为83.33%(95%置信区间:51.59-97.91)。
本研究成功确定了PLD联合IFO和rhG-CSF治疗晚期STS的MTD,提供了一种具有可耐受安全性的潜在有价值的治疗选择。