Nonmetastatic osteosarcoma of the extremity. Neoadjuvant chemotherapy with methotrexate, cisplatin, doxorubicin and ifosfamide. An Italian Sarcoma Group study (ISG/OS-Oss)

Abstract

This study confirms that in nonmetastatic osteosarcoma of the extremity, conservative surgery in more than 90% and a good pathologic response rate of 50% can be expected with primary chemotherapy based on the MAP regimen. The response and resection rates in the ISG/OS-Oss study are in the same range as those of the previous study, whereas the event-free survival is lower than that previously achieved. Since the only difference between the two studies was the cumulative dose of postoperatively given MTX, our data support the importance of the cumulative dose of MTX in the MAP regimen.

Risk-Based Therapy for Localized Osteosarcoma

“…Ferrari et al added ifosfamide to standard MAP regimen in poor responders. [23] The 5-year EFS of 50% was less than the EFS of 64% achieved in a previous trial with MAP regimen conducted by the same group. The authors concluded that the reduction in methotrexate dose or dose intensity, due to the addition of ifosfamide, was responsible for the worse outcome.…”

“…Other groups have investigated the addition of alkylators for poor responders to improve outcome. Ferrari et al added ifosfamide to standard MAP regimen in poor responders . The 5‐year EFS of 50% was less than the EFS of 64% achieved in a previous trial with MAP regimen conducted by the same group.…”

Prognostic value of abnormally expressed long non-coding RNAs in patients with osteosarcoma: a meta-analysis

“…Although advances in tumor treatment strategy have significantly raised the survival rate of osteosarcoma patients, the survival of osteosarcoma patients with metastatic disease or recurrences and those in advanced stage is still quite poor [3,[6][7][8]. Thus, novel promising biomarkers of osteosarcoma that can help in diagnosis and prognosis evaluation are still urgently needed.…”

“…This devastating tumor is characterized by its high aggressive ability and early systematic metastasis, approximately 20% of osteosarcoma patients present with detectable lung metastatic disease at initial diagnosis, additionally, about 40% of patients free of metastasis will progress to Oncotarget 2 www.impactjournals.com/oncotarget metastasis in later stages during treatment [4]. With the application of chemotherapy, a combination of neoadjuvant chemotherapy, surgery resection and postoperative chemotherapy has clinically become the standard treatment strategy for osteosarcoma and has significantly improved patients' outcome, the 5-year overall survival of patients with nonmetastatic osteosarcoma of the extremity has approached to 70%~80% over past decades [5,6]. However, the 5-year overall survival rate of osteosarcoma patients with detectable metastases at diagnosis is as low as 19% [7].…”

Osteosarcoma – on the way to personalized therapy. Part I: standard chemotherapy in the present

“…Ferrari и соавт. [30] представили данные объединенного исследования Итальянской и Скандинавской групп (ISG/SSG I), проведенного с 1997 по 2000 г. В исследование были включены 182 пациента. Особенность неадъювантной химиотерапии -применение двух курсов монотерапии высокодозным ифосфамидом (в курсовой дозе 15 г/м 2 ) и двух курсов МАР: метотрексат (M) 12 г/м 2 , доксорубицин (А) 75 мг/м 2 , цисплатин (Р) 120 мг/м 2 в альтернирующем режиме.…”