Initial systemic chemotherapy for advanced progressive soft tissue sarcoma

PLD: pegylated liposomal doxorubicin.
* Anthracycline-sensitive histologies include liposarcoma, leiomyosarcoma, epithelioid sarcoma, synovial sarcoma, angiosarcoma, undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor.
¶ For select examples, refer to UpToDate topic on systemic treatment of metastatic soft tissue sarcoma.
Δ Relative contraindications to doxorubicin include clinical heart failure and cumulative lifetime treatment with >400 mg/m² doxorubicin in the adjuvant or neoadjuvant setting.
◊ Doxorubicin plus ifosfamide is an option for synovial sarcoma, myxoid/round cell liposarcoma, and other anthracycline-sensitive tumors that are symptomatic and would benefit from the higher objective response rates that are typically seen with this regimen as compared with doxorubicin alone.