Soft Tissue Sarcoma with Jonathan C. Trent, MD, PhD and Shreyaskumar R. Patel, MD: Case 1 - Episode 3
What is the risk:benefit of using ifofsamide in this patient?
Ifosfamide is a drug that is not very user friendly. There are issues related to administration in terms of prolonged schedule requirements. In terms of toxicity, it is not a very friendly drug either. Consequently, one needs to be very careful as to where they use the drug, specifically for patients with leiomyosarcomas. Uterine leiomyosarcomas do tend to respond to ifosfamide, but ex-gynecologic-originating leiomyosarcomas may not be so sensitive. There are data to support this.
CASE: Soft-Tissue Sarcoma (Part 1)
Rachel F is a 58-year-old school teacher from Roanoke, Virginia. Her medical history is notable for mild hypertension and total knee replacement in 2011
Follow-up CT scan in January 2014 showed progression at multiple sites; at the time of follow up, her ECOG performance status was 1, with renal and hepatic function within normal limits
In September of 2014 she returns for follow-up, unable to work with increasing fatigue and abdominal pain, and her CT scan was consistent with progressive disease
After 4 months of therapy, she presents with worsening abdominal pain and declining performance status