
<b>AIM is the combination of Adriamycin [doxorubicin] and Ifex [ifosfamide, sometimes spelled iphosphamide] and Mesna [a urinary tract protector for use with Ifex].</b>  It is a classic combination, which is still used today.  The other classic combination, MAID
[ which is AIM + DTIC[dacarbazine] is not used very much today, because of its toxicity].

AIM can be a difficult chemotherapy agent to take, as it is quite potent, and the side effect profile is noticeable.  Colony stimulating agents are usually needed to help keep the white counts up.  Colony stimulating agents are substances given by injection which helps the bone marrow recover from the effects of the chemotherapy agents.  The most worrisome is the white cell population, because if it falls too low life threatening infection occurs.  

<b>Search Pubmed for &&url
<b>Search Pubmed for &&url</b>

<b>ONE EXAMPLE OF AIM CLINICAL TRIALS [for more complete information see the search above]</b>

<b>Randomized phase III study comparing conventional-dose doxorubicin plus ifosfamide versus high-dose doxorubicin plus ifosfamide plus recombinant human granulocyte-macrophage colony-stimulating factor in advanced soft tissue sarcomas: A trial of the European Organization for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group.</b>

J Clin Oncol 2000 Jul;18(14):2676-84
Le Cesne A, Judson I, et al

PURPOSE: This randomized multicenter study was designed to compare the activity of a high-dose doxorubicin-containing chemotherapy regimen with a conventional standard-dose regimen in adult patients with advanced soft tissue sarcomas (ASTS).

...Between 1992 and 1995, 314 patients were randomized to receive a standard-dose regimen (arm A), containing doxorubicin (50 mg/m(2) on day 1) and ifosfamide (5 g/m(2) on day 1), or an intensified regimen (arm B), combining doxorubicin (75 mg/m(2) on day 1), the same ifosfamide dose, and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF; sargramostim, 250 microgram/m(2) on days 3 to 16); all courses were repeated every 3 weeks.  ...

Thirty-eight percent and 23% of patients presented with leiomyosarcomas and liver metastases, respectively.

Objective responses were observed in 31 (21%) of 147 assessable patients in arm A and in 31 (23.3%) of 133 in arm B (P = .65). No change was observed in 41.6% and 46.2% of patients in arm A and B, respectively.

Progression-free survival (PFS) was significantly longer in the intensive arm (P = .03). The median duration of the time to progression was 19 weeks in the conventional arm and 29 weeks in the intensified arm.

There was no difference in overall survival (P = .98) between the two therapeutic arms.

Toxicities were manageable in both arms. 
... Despite a 50% increase of the doxorubicin dose-intensity, the high-dose regimen failed to demonstrate any impact on survival in patients with ASTS.

The low complete response rate, the high incidence of leiomyosarcomas, and liver metastases may in part explain these results.

However, the lengthening of the PFS in the intensive arm, because of the quality of stable disease and inappropriate tumor evaluation policies that potentially lead to an underestimation of antitumor activity, does not definitively refute the use of a high-dose chemotherapy regimen in selected patients with ASTS.   
&&url PMID: 10894866 
