Results of API-AI based regimen in osteosarcoma adult patients included in the French OS2006/Sarcome-09 study.
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Bone Neoplasms
/ mortality
Cisplatin
/ administration & dosage
Disease-Free Survival
Doxorubicin
/ administration & dosage
Drug Administration Schedule
Etoposide
/ administration & dosage
Feasibility Studies
Female
Follow-Up Studies
France
/ epidemiology
Humans
Ifosfamide
/ administration & dosage
Kaplan-Meier Estimate
Male
Methotrexate
/ administration & dosage
Middle Aged
Neoadjuvant Therapy
/ adverse effects
Osteosarcoma
/ mortality
Prognosis
Survival Rate
Young Adult
Zoledronic Acid
/ administration & dosage
adult patients
doxorubicin-cisplatin-ifosfamide regimen
osteosarcoma
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 01 2020
15 01 2020
Historique:
received:
27
12
2018
accepted:
28
05
2019
pubmed:
28
6
2019
medline:
20
2
2020
entrez:
28
6
2019
Statut:
ppublish
Résumé
In the OS2006 study, patients younger than 18 years were treated with a methotrexate-based regimen (MTX), patients older than 25 years with a doxorubicin-cisplatin-ifosfamide-based regimen (API-AI), whereas patients aged 18-25 years received either API-AI or MTX. We herein report the prespecified subgroup analysis of the outcome of 106 patients treated with API-AI. Preoperative chemotherapy combined three doxorubicin-ifosfamide-cisplatin (API) and two doxorubicin-ifosfamide (AI) courses. Postoperative chemotherapy was assigned by risk group: localised patients with a good histological response (<10% viable cells) received two AI and two cisplatin-ifosfamide (PI) courses; patients with synchronous metastases, poor histological response or unresectable primary received five cycles of etoposide-ifosfamide (EI). Of the 106 patients, 61 were randomised to receive or not zoledronate. Median age was 30 years (range 18-67), 66 (62%) patients were >25 years. The primary tumours were axial in 28 patients (26%), and 28 (26%) presented with metastases. Ninety-six patients (91%) had surgery, conservative in 82 (85%); 36 patients (38%, 95% CI 28-48%) were good responders. Toxicity was manageable, with no significant difference in severe acute toxicity between patients aged >25 years and those younger. With a median follow-up of 4.8 years, the 5-year event-free survival and overall survival rates were 46% (95% CI 36-56) and 57% (95% CI 47-67), respectively. The primary tumour size and initial metastases correlated with a higher risk of event. In these 106 osteosarcoma adult patients, API-AI proved feasible with no excess of toxicity, and favourable activity despite poor-prognosis factors.
Substances chimiques
Etoposide
6PLQ3CP4P3
Zoledronic Acid
6XC1PAD3KF
Doxorubicin
80168379AG
Cisplatin
Q20Q21Q62J
Ifosfamide
UM20QQM95Y
Methotrexate
YL5FZ2Y5U1
Types de publication
Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
413-423Informations de copyright
© 2019 UICC.
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