Treatment of osteosarcoma at first recurrence after contemporary therapy

Aim: To determine the outcome for patients with recurrent OS who were treated at MSKCC at the time of first recurrence.

Conclusions: At first recurrence, 22 of 31 patients achieved a CR2 with aggressive surgery and chemotherapy. The majority of these patients subsequently developed a disease recurrence. Patients appeared to benefit from the addition of ifosfamide to their retrieval regimens. In the end, the role of chemotherapy in recurrent OS continues to remain undefined.

Official Title

Treatment of osteosarcoma at first recurrence after contemporary therapy

Conditions

Study Type

Retrospective chart review

Study Design

Treatment:Surgery alone: 4 patientsChemotherapy alone: 8 patientsChemotherapy + surgery: 31 pts ifosfamide (at dose of 2.8 g/m2 x 5d) in combination with etoposide was used most commonly

Further Details

Efficacy:Surgery alone: 3 patients alive (lung metastases only)Chemotherapy alone: none survived (unresectable disease)Chemotherapy + surgery: 22 patients achieved a second CR (CR2).3-y OS: 42%3-y RFS: 18%Long-term remission: 9/31 (29%)Regimens that contain ifosfamide appeared to confer an advantage:CR2 + IFO: 18/23 vs. IFO 4/8 Tolerability: Three patients in CR2 died: secondary leukemia / sepsis / acute respiratory distress syndrome.

Study Start

Eligibility & Criteria

Indication: Recurrent Osteosarcoma (OS)Eligibility: Biopsy-proven high-grade OS; documented CR after primary surgery and primary chemotherapy with at least three of the following agents: high-dose methotrexate, cisplatin, doxorubicin, ifosfamide (at dose of 1.8 g/m2 x 5d)

Total Enrolment

43

Contact Details

Chou,A.J.; Merola,P.R.; Wexler,L.H.; Gorlick,R.G.; Vyas,Y.M.; Healey,J.H.; LaQuaglia,M.P.; Huvos,A.G.; Meyers,P.A.Institution: Memorial Sloan-Kettering Cancer Center. New York, NY, USACancer 104 (2005): 2214-2221