
These are both classic agents that have been around for a while.  The combination is more toxic than the individual agents.  The survival time is not increased by the combination.  BUt the response rate IS increased.  If one needs a quick response to quickly achieve operability, this might help.

Below is a comparison study between two different doses of doxorubicin [Adriamycin] and a cocktail of doxorubicin [Adriamycin] + dacarbazine [DTIC].

"[the addition of]  DTIC [to adriamycin] did not influence survival (median, 8.0 months) or increase the number of complete responses " but did increase the response rate.

The reason a response does not always increase survival time, is that the tumor regrows quickly.  IF, however, that response allows for complete resection of inoperable tumor, then different statistics apply.

<b>Search Pubmed for &&url
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Randomized comparison of three adriamycin regimens for metastatic soft tissue sarcomas.</b>
J Clin Oncol 1987 Jun;5(6):840-50
Borden EC, Amato DA, Rosenbaum C, Enterline HT, Shiraki MJ, Creech RH, Lerner HJ, Carbone PP.

"This study addressed two major questions regarding therapeutic use of Adriamycin ...in adult soft tissue sarcomas: the influence of dosing schedule and the value of adding ... DTIC ... The regimens using Adr as a single agent resulted in an equivalent response frequency (18% and 16%) and survival (median, 8.0 and 8.4 months). DTIC significantly increased ...the overall response frequency of Adr to 30%. However, DTIC did not influence survival (median, 8.0 months) or increase the number of complete responses." 

"The toxicities of the two single-agent regimens differed: ... DTIC resulted in substantially increased toxicity, primarily gastrointestinal ...; overall, 98% of patients receiving Adr-DTIC experienced moderate or worse toxicity. ...

"The most common histological subtype entered was leiomyosarcoma (99 patients). The response to Adr-DTIC of this subtype was higher (44%) than that of any other subtype. However, this difference alone was not responsible for the overall superiority of the combination. This confirmed that the combination of DTIC plus Adr adds to the response rate of Adr alone in soft tissue sarcomas.  Whether the increased response frequency, without an impact on survival, is worth the significantly greater toxicity remains a subjective judgement that must be made within the context of the individual patient."   
&&url PMID: 3585441
