There is limited role for chemotherapy in second line for soft tissue sarcoma, although in first line it has some effect. Fixed-dose-rate gemcitabine and docetaxel achieved high objective response rates in three prospective phase II studies as first-line or second-line therapy for advanced uterine leyomyosarcoma. In a randomized trial, the combination of gemcitabine and docetaxel was superior to gemcitabine alone in terms of objective response, progression-free, and overall survival among patients with soft-tissue sarcoma, most of whom had received at least one prior cytotoxic regimen.Currently, NCCN recommends several combinations for metastatic soft tissue sarcoma, among them Gemzar and Taxotere (SARC-E, 1). Gemcitabine and docetaxel is an acceptable combination for metastatic leiomyosarcoma but it is not proven for adjuvant therapy. There are several studies looking at this, among them: Adjuvant Docetaxel Plus Gemcitabine in Patients With Completely Resected Leiomyosarcoma (LMS) of the Uterus, NCT00614835.
Currently, NCCN recommends several combinations for metastatic soft tissue sarcoma, among them ifosfamide and adriamycin (SARC-E, 1) but for first line and there is no specific regimen for second line therapy.
A recent review found that study has shown that more than 20% of soft tissue sarcoma patients treated with second-line chemotherapy can obtain prolonged benefit for over 6 months. In addition, confirmed responses were observed in a small proportion of patients who did not respond to first-line chemotherapy.This was not a prospective phase III trial and the conclusion needs to be confirmed and replicated.
Janice N. Cormier, MD, MPH and Raphael E. Pollock, MD, PhD, Soft Tissue Sarcomas CA Cancer J Clin 2004; 54:94-109
Hensley, Martee L Update on gemcitabine and docetaxel combination therapy for primary and metastatic sarcomas Current Opinion in Oncology: July 2010 – Volume 22 – Issue 4 – p 356–361
Anna Minchom et al, Clinical Benefit of Second-Line Palliative Chemotherapy in Advanced Soft-Tissue Sarcoma. Sarcoma Volume 2010 (2010),