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Forum Name: Sarcoma

Question: Follicular sarcoma of abdominal wall treatment with caelyx?


 eva_3012 - Sat Jan 10, 2009 5:29 am

Dear Doctor,

I'm trying to help a friend of mine who doesn't speak English.
This is very important and very urgent, we can't find any other source of info.
Her husband is 36 y/o. Had undergone 2 operations, after which has been diagnosed with follicular sarcoma of abdominal wall. Has undergone 1st course of chemio, and he needs another 5. They are from Latvia, their Doctor has found out that that treatment with New drug Doxorubicin hydrohlorid liposomal (Cae Lyx 50mg/25 ml), a way to go, although she never worked with the drug before. It seems that the drug is new and very expensive, my friend would like to find out other independant opinion with reagrds of treating the particullar sarcoma with this drug. Whether it s practised and has positive results? She can't find the drug in Latvia or neighbouring countries but doctor insists on that drug, should they go ahead with it? The treatment should start in 1weeks time.

Thank you very much
Eva
 Dr. Tamer Fouad - Sat Jan 10, 2009 10:13 am

User avatar Hello,

I am sorry to hear about your friend's husband. Follicular dendritic cell sarcoma is a VERY rare cancer. It has been reported in around 100 cases in the medical literature. So I am afraid there are very few doctors who have experienced treating this extremely rare disease.

This also means that there is no 'recommended' regimen that is based on strong experimental evidence. This is because of rarity of the disease makes it impossible to recruit a minimum number of patients for a clinical trial.

As regards the presumed origin of this tumor it is presumed to be a non-lymphoid cell-derived tumor that originates from B-lymphoid follicles of nodal and extranodal sites.

That said, most of the cases that were treated have been treated with chemotherapy have received either classical lymphoma chemotherapy (CHOP regimen) or classical sarcoma regimens (Ifosfamide doxorubicin regimen or gemcitabine-taxane regimen).

I am attaching a link to a medical article published in the American Journal of Hematology in 2007 reporting on 14 cases treated at the M.D. Anderson Cancer Research Center.

Follicular dendritic cell sarcoma - A report of 14 cases and a review of the literature

I am also attaching the correspondence address in that article:
Barbara Pro,
Department of Lymphoma and Myeloma, Unit 429,
The University of Texas M.D. Anderson Cancer Center,
1515 Holcombe Boulevard, Houston, TX 77030

Email address: bpro@mdanderson.org

Regarding Caelyx. It's not really a new drug it's a better preparation of a very old drug that is very widely used in chemotherapy regimens. It's the famous red drug called doxorubicin. The liposomal preparation confers less toxicity and better delivery of the drug. The only article I could find about the use of Caelyx in the treatment follicular dendritic sarcoma was reported by a group at the University of Rome Italy. It is a single case report and the treatment is given as adjuvant (meaning after surgery). I read the article and the author does not cite any references for this form of use or the use of Caelyx in this setting. Indeed he specifically states that he does not know of any previous incidents of its use.

Follicular dendritic cell sarcoma of the neck: Report of a case treated by surgical excision and COP plus (PEG)-liposomal doxorubicin

I hope this information has helped.

Best regards,

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