Doxorubicin Hydrochloride or Trabectedin in Treating Patients With Previously Untreated Advanced or Metastatic Soft Tissue Sarcoma

This is an interventional treatment trial for Sarcoma focused on measuring stage III adult soft tissue sarcoma, stage IV adult soft tissue sarcoma, adult alveolar soft-part sarcoma, adult angiosarcoma, adult desmoplastic small round cell tumor, adult epithelioid sarcoma, adult extraskeletal chondrosarcoma, adult extraskeletal osteosarcoma, adult fibrosarcoma, adult leiomyosarcoma, adult malignant fibrous histiocytoma, adult malignant hemangiopericytoma, adult malignant mesenchymoma, adult neurofibrosarcoma, adult synovial sarcoma Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed intermediate- or high-grade malignant soft tissue sarcoma

  • Advanced and/or metastatic disease
  • Previously untreated disease

• The following tumor types are not allowed:

  • Well-differentiated liposarcoma
  • Embryonal rhabdomyosarcoma
  • Chondrosarcoma (excluding extraskeletal myxoid chondrosarcoma)
  • Osteosarcoma (excluding extraskeletal osteosarcoma)
  • Ewing tumors/primitive neuroectodermal tumor (PNET)
  • Gastrointestinal stromal tumors (GIST)
  • Dermatofibrosarcoma protuberans
• Must have confirmed disease progression based on investigator's judgment prior to study enrollment

• Measurable disease according to RECIST v 1.1 criteria

  • Tumor lesions situated in a previously irradiated area, or in an area subjected to other loco-regional therapy, are usually not considered measurable unless there has been demonstrated progression in the lesion
• Formalin fixed paraffin embedded tumor blocks or representative hematoxylin/eosin slides (preferably both) available (local histopathological diagnosis will be accepted for trial entry)

• No prior anticancer therapy for this disease

  • No prior anthracycline
  • Non-anthracycline therapy for nonmetastatic disease is acceptable
• No known history of CNS metastases or leptomeningeal tumor spread

PATIENT CHARACTERISTICS:

• WHO performance status 0-1
• Absolute neutrophil count ≥ 1.5 x 10^9/L
• Hemoglobin ≥ 9 g/dL
• Platelet count ≥ 100 x 10^9/L
• Bilirubin normal
• ALT/AST ≤ 2.5 times upper limit of normal (ULN)
• Alkaline phosphatase ≤ 2.5 times ULN, (if alkaline phosphatase > 2.5 times ULN, hepatic isoenzymes 5-nucleotidase and/or GGT must be within the normal range)
• Albumin > 30 g/L
• Serum creatinine ≤ 1.5 times ULN
• Creatinine clearance ≥ 30 mL/min
• Creatine phosphokinase (CPK) ≤ 2.5 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception (double barrier method for men) 2 weeks prior to, during, and for 3 months (women) or 5 months (men) after completion of study therapy
• LVEF normal by MUGA scan or ECHO
• 12-lead ECG normal (without clinically significant abnormalities)

• None of the following unstable cardiac conditions:

  • Congestive heart failure
  • Angina pectoris
  • Myocardial infarction within the past year
  • Uncontrolled arterial hypertension, defined as BP ≥ 150/100 mm Hg despite optimal medical therapy
  • Clinically significant arrhythmias

• No active or uncontrolled infections or serious illnesses or medical conditions, including a history of any of the following:

  • Chronic alcohol abuse
  • Hepatitis
  • HIV
  • Cirrhosis

• No history of malignancy within the past 5 years, except soft tissue sarcoma, basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, resected incidental prostate cancer (staged pT2 with Gleason score ≤ 6 and postoperative PSA < 0.5 ng/mL)

  • Patients with any history of malignancies who are disease-free for more than 5 years are eligible
• a history of malignancy and disease-free for more than 5 years
• No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
• No concurrent alcohol consumption

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• At least 28 days since prior and no concurrent anticancer therapy including systemic therapy, radiotherapy, or surgery
• At least 28 days since prior and no other concurrent investigational agents
• No concurrent phenytoin, live attenuated vaccines, or yellow fever vaccine