Improved tolerability of chemotherapy in soft tissue sarcomas: old and new strategies

Anthracyclines and alkylating agents (ifosfamide, Mitoxana®) are the mainstays of chemotherapy for soft tissue sarcoma and as there is a close correlation between dose- intensity and response, methods should be developed to ameliorate the clinical tolerability of these agents. Improvements in the efficacy of medical treatments for soft tissue sarcomas may derive from old strategies by aiming to counteract the side effects of standard chemotherapy regimes and from new, less toxic, anticancer drugs. This paper reviews the currently available options for reducing the cardiotoxicity of anthracyclines, the role of growth factors and autologous stem cell transplantation in dose-intensification of chemotherapy and also examines the clinical impact of the more promising new agents.