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Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma: a report from the Children's Oncology Group.
Cancer. 2009 Nov 15; 115(22):5339-48.C

Abstract

BACKGROUND

The addition of liposomal muramyl tripeptide phosphatidylethanolamine (MTP-PE) to chemotherapy has been shown to improve overall survival in patients with nonmetastatic osteosarcoma (OS). The authors report the results of addition of liposomal MTP-PE to chemotherapy for patients with metastatic OS.

METHODS

Intergroup-0133 was a prospective randomized phase 3 trial for the treatment of newly diagnosed patients with OS. The authors compared 3-drug chemotherapy with cisplatin, doxorubicin, and high-dose methotrexate (Regimen A) to the same 3 drugs with the addition of ifosfamide (Regimen B). The addition of liposomal MTP-PE to chemotherapy was evaluated.

RESULTS

Five-year event-free survival (EFS) for patients who received liposomal MTP-PE (n = 46) was 42% versus 26% for those who did not (n = 45) (relative risk for liposomal MTP-PE, 0.72; P = .23; 95% confidence interval [CI], 0.42-1.2). The 5-year overall survival for patients who received MTP-PE versus no MTP-PE was 53% and 40%, respectively (relative risk for liposomal MTP-PE, 0.72; P = 0.27; 95% CI, 0.40-1.3). The comparison of Regimen A with Regimen B did not suggest a difference for EFS (35% vs 34%, respectively; relative risk for Regimen B, 1.07; P = .79; 95% CI, 0.62-1.8) or overall survival (52% vs 43%, respectively; relative risk for Regimen B, 1.1, P = .75; 95% CI, 0.61-2.0).

CONCLUSIONS

When the metastatic cohort was considered in isolation, the addition of liposomal MTP-PE to chemotherapy did not achieve a statistically significant improvement in outcome. However, the pattern of outcome is similar to the pattern in nonmetastatic patients.

Authors+Show Affiliations

Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19637348

Citation

Chou, Alexander J., et al. "Addition of Muramyl Tripeptide to Chemotherapy for Patients With Newly Diagnosed Metastatic Osteosarcoma: a Report From the Children's Oncology Group." Cancer, vol. 115, no. 22, 2009, pp. 5339-48.
Chou AJ, Kleinerman ES, Krailo MD, et al. Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma: a report from the Children's Oncology Group. Cancer. 2009;115(22):5339-48.
Chou, A. J., Kleinerman, E. S., Krailo, M. D., Chen, Z., Betcher, D. L., Healey, J. H., Conrad, E. U., Nieder, M. L., Weiner, M. A., Wells, R. J., Womer, R. B., & Meyers, P. A. (2009). Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma: a report from the Children's Oncology Group. Cancer, 115(22), 5339-48. https://doi.org/10.1002/cncr.24566
Chou AJ, et al. Addition of Muramyl Tripeptide to Chemotherapy for Patients With Newly Diagnosed Metastatic Osteosarcoma: a Report From the Children's Oncology Group. Cancer. 2009 Nov 15;115(22):5339-48. PubMed PMID: 19637348.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma: a report from the Children's Oncology Group. AU - Chou,Alexander J, AU - Kleinerman,Eugenie S, AU - Krailo,Mark D, AU - Chen,Zhengjia, AU - Betcher,Donna L, AU - Healey,John H, AU - Conrad,Ernest U,3rd AU - Nieder,Michael L, AU - Weiner,Michael A, AU - Wells,Robert J, AU - Womer,Richard B, AU - Meyers,Paul A, AU - ,, PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2009/12/29/medline SP - 5339 EP - 48 JF - Cancer JO - Cancer VL - 115 IS - 22 N2 - BACKGROUND: The addition of liposomal muramyl tripeptide phosphatidylethanolamine (MTP-PE) to chemotherapy has been shown to improve overall survival in patients with nonmetastatic osteosarcoma (OS). The authors report the results of addition of liposomal MTP-PE to chemotherapy for patients with metastatic OS. METHODS: Intergroup-0133 was a prospective randomized phase 3 trial for the treatment of newly diagnosed patients with OS. The authors compared 3-drug chemotherapy with cisplatin, doxorubicin, and high-dose methotrexate (Regimen A) to the same 3 drugs with the addition of ifosfamide (Regimen B). The addition of liposomal MTP-PE to chemotherapy was evaluated. RESULTS: Five-year event-free survival (EFS) for patients who received liposomal MTP-PE (n = 46) was 42% versus 26% for those who did not (n = 45) (relative risk for liposomal MTP-PE, 0.72; P = .23; 95% confidence interval [CI], 0.42-1.2). The 5-year overall survival for patients who received MTP-PE versus no MTP-PE was 53% and 40%, respectively (relative risk for liposomal MTP-PE, 0.72; P = 0.27; 95% CI, 0.40-1.3). The comparison of Regimen A with Regimen B did not suggest a difference for EFS (35% vs 34%, respectively; relative risk for Regimen B, 1.07; P = .79; 95% CI, 0.62-1.8) or overall survival (52% vs 43%, respectively; relative risk for Regimen B, 1.1, P = .75; 95% CI, 0.61-2.0). CONCLUSIONS: When the metastatic cohort was considered in isolation, the addition of liposomal MTP-PE to chemotherapy did not achieve a statistically significant improvement in outcome. However, the pattern of outcome is similar to the pattern in nonmetastatic patients. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/19637348/Addition_of_muramyl_tripeptide_to_chemotherapy_for_patients_with_newly_diagnosed_metastatic_osteosarcoma:_a_report_from_the_Children's_Oncology_Group_ L2 - https://doi.org/10.1002/cncr.24566 DB - PRIME DP - Unbound Medicine ER -