Key result
Adding dexrazoxane to doxorubicin and olaratumab limits cardiotoxicity to ~7% in advanced sarcoma.
Why the study?
Anthracycline-associated cardiotoxicity is a challenge that dexrazoxane may reduce, prompting the study to evaluate overall survival, cardiotoxicity incidence, and dexrazoxane use in soft tissue sarcoma patients treated with doxorubicin and olaratumab.
Does the addition and timing of dexrazoxane reduce cardiotoxicity without compromising overall survival in adults with soft tissue sarcoma treated with doxorubicin and olaratumab?
Cohort (n=106)
Yes
Does the addition and timing of dexrazoxane reduce cardiotoxicity without compromising overall survival in adults with soft tissue sarcoma treated with doxorubicin and olaratumab?
In patients with soft tissue sarcoma treated with doxorubicin and olaratumab, the use of dexrazoxane was associated with a low incidence of cardiotoxicity (7%) and an overall survival consistent with prior reports.
Answers are grounded in this paper and cite their sources.
Supports early dexrazoxane with doxorubicin-olaratumab to limit cardiotoxicity; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND AND PURPOSE: Anthracycline-associated cardiotoxicity is a challenge that dexrazoxane may reduce. The aim of this study was to report the overall survival (OS), incidence of cardiotoxicity and dexrazoxane use in a Danish population-based cohort of patients with soft tissue sarcoma (STS) treated with doxorubicin, olaratumab and dexrazoxane. PATIENTS/MATERIAL AND METHODS: We performed a retrospective study of adults (≥18 years) with locally advanced or metastatic STS treated with doxorubicin, olaratumab and dexrazoxane between 2015 and 2019 at Herlev University Hospital (Herlev) and Aarhus University Hospital (Aarhus). Dexrazoxane was administered from cycle 1 at Herlev and from cycle 4 at Aarhus. OS was measured from doxorubicin initiation to death. Cardiotoxicity was defined as a >10 percentage‑point decline in left ventricular ejection fraction to <50% compared with baseline. RESULTS: In total, 106 patients were included: 71 patients (67%) from Herlev and 35 (33%) from Aarhus. Mean age was 59 years, 59% were female. Median OS was 18 months (95% confidence interval [CI]: 11.0-20.7) and median cumulative doxorubicin dose was 320.7 mg/m² (range: 37.5-605.4). Dexrazoxane was administered to 68 patients (96%) at Herlev and 18 (51%) at Aarhus. Seven patients (7%) developed cardiotoxicity (Herlev n = 4; Aarhus n = 3). Median OS was 19.6 months at Herlev and 14.8 months at Aarhus (p = 0.24). Neutropenic fever occurred in 27 patients (38%) at Herlev and six patients (17%) at Aarhus (p = 0.88). INTERPRETATION: Doxorubicin with olaratumab and dexrazoxane resulted in a low incidence of cardiotoxicity and OS was consistent with previously reported.
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Vitfell-Rasmussen et al. (2026) conducted a cohort in locally advanced or metastatic soft tissue sarcoma (n=106). Doxorubicin, olaratumab, and dexrazoxane was evaluated on Overall survival (95% CI 11.0-20.7). In adults with advanced soft tissue sarcoma, treatment with doxorubicin, olaratumab, and dexrazoxane resulted in a median overall survival of 18 months and a low 7% incidence of cardiotoxicity.
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