
<b>DMAP chemotherapy treatment can also bring significant response, in a large number of patients but is VERY toxic.</b>  

It is composed of the individual chemotherapy agents
DTIC [dacarbazine]
Mitomycin
Adriamycin [doxorubicin]
cisPlatin

DMAP was tried on a small group, with a response rate of 80% for ULMS, and 37% for NONuterine LMS.  It is probably the worst of all of these cocktails for side effects and terrible Quality of Life while on it, and burns out your bone marrow very well.  However, 2 of the 3 uterine LMS patients who had interval surgery have had 2 year remissions.  It contains Adriamycin [doxorubicin], so those who have used up a lifetime limit of Adriamycin cannot use it.

It is a Mayo clinic regime.  In one ULMS listmember with a mitotic index of 60, it brought a complete remission, after 3 of 4 cycles, but within a three month period disease recurred.  Further treatment with chemo agents was somewhat hampered by bone marrow being impaired by the DMAP regime.

<b>Search Pubmed for &&url
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One of the abstracts from the literature on DMAP:

Contrast of response to dacarbazine, mitomycin, doxorubicin, and cisplatin (DMAP) plus GM-CSF between patients with advanced malignant gastrointestinal stromal tumors and patients with other advanced leiomyosarcomas.</b>

Cancer Invest 2002;20(5-6):605-12
Edmonson JH, Marks RS, Buckner JC, Mahoney MR. 
Mayo Clinic, Rochester, MN 

"...Adult patients with advanced leiomyosarcomas received intravenous chemotherapy as outpatients with dacarbazine 750 micrograms/m2, mitomycin 6 mg/m2, doxorubicin 40 mg/m2, and cisplatin 60 mg/m2 on day 0, with granulocyte macrophage colony stimulating factor (GM-CSF, sagramostim) 250 mcg/m2 given s.c. every 12 hr on days -6 to -3 and on days 1-14 of each 4-week treatment cycle."

"... We studied 21 patients with GIST and 18 patients with other types of leiomyosarcomas, "

"Toxicity was significant, ...In one patient, grade 4 pulmonary toxicity developed ... and was considered a major factor in her death."

"Objective tumor regression was observed in one of 21 (1.8%) ... GIST and in 11 of 18 (61%) ... other leiomyosarcomas, including eight of 10 uterine cases."  "In five cases, we interrupted chemotherapy to attempt complete surgical excision of residual tumor, and four of the patients were rendered apparently free of disease."

"Median survivals for the two groups have been similar with 16.7 months (95%CI = 8.8-27.5 months) for the GIST and 17.5 mos (95%CI = 10.9-35.3%) for the other leiomyosarcomas. Three patients with uterine leiomyosarcomas are still alive more than 2 years after completing this chemotherapy and subsequent secondary surgical excision (+/- irradiation) and two of them are free of disease."

"While this regimen is ineffective against GIST, its value against uterine leiomyosarcomas deserves further study in a larger population." 
&&url PMID: 12197215
