Chemotherapy and stem cells combat osteosarcoma

Neoadjuvant high-dose chemotherapy in combination with autologous peripheral blood stem cell transplantation is an effective means of treating nonmetastatic high-grade localized osteosarcoma, Turkish researchers report.

“We believe that the high tumor necrosis and survival rate, acceptable toxicity rate, minor surgical complications, good functionality results and short length of treatment are important advantages,” lead investigator Dr. Fikret Arpaci told Reuters Health.Dr. Arpaci and colleagues at GATA Gulhane Faculty of Medicine, Ankara, conducted a phase II study with 22 patients with high-grade localized osteosarcoma. They received two cycles of induction chemotherapy with cisplatin, doxorubicin, and ifosfamide, followed by high-dose chemotherapy.The subjects underwent autologous peripheral blood stem cell support or transplantation, limb-sparing surgery and three to six cycles of postoperative chemotherapy.The most frequent grade 3 and 4 toxicities associated with chemotherapy included leukopenia, anemia and thrombocytopenia. No patient died of chemotherapeutic toxicity, according to the report in the September 1st issue of Cancer.After a median follow-up of almost 2 years, 82% of patients had a tumor necrosis rate of at least 90%. The 3-year overall survival was 83% and the disease-free survival was 70%. “At the time of the last follow-up, 17 patients were still alive and free of disease,” the researchers report.Dr. Arpaci’s team also points out that the “short duration of therapy and the feasibility of limb-sparing surgery in all patients are additional advantages of this approach.”(Source: Cancer 2005;104:1058-1065: Reuters Health: Oncolink: September 2005.)