Tags

Type your tag names separated by a space and hit enter

Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years.

Abstract

Purpose:

The French standard chemotherapy for osteosarcoma combines high-dose methotrexate (HDM) and etoposide-ifosfamide (EI) in children and adolescents, and API-AI (doxorubicin-cisplatin-ifosfamide) in adults. We herein present the results of M-EI and API-AI in 18- to 25-year-old patients.

Methods:

Patients, 18-25 years old, received either M-EI or API-AI regimens. M-EI comprised seven M and two EI doses preoperatively then M-EI in standard-risk patients (good histological response without metastasis) and five M-AP (methotrexate-doxorubicin-cisplatin) in high-risk patients (poor histological response, metastasis, and/or unresectable primary), postoperatively. API-AI comprised three API and two AI doses preoperatively, then two AI and two PI in standard-risk patients and five EI in high-risk patients, postoperatively.

Results:

We analyzed 95 patients 18-25 years of age: 55 received M-EI and 40 API-AI. The groups had similar baseline characteristics. Eighty-nine patients (94%) had surgery. Twenty-nine of 55 M-EI patients (60%) and 16/40 API-AI patients (41%) had good histological responses to preoperative chemotherapy. At 5 years, event-free survival was 50% (95% confidence interval [CI]: 39-60) and overall survival was 65% (95% CI: 54-74). Acute toxicity was similar, without treatment-related deaths.

Conclusions:

Survival outcomes with M-EI and API-AI were not significantly different. Tolerance was acceptable with both regimens. HDM is thus feasible for young adults. However, our study limitations preclude any definitive conclusions.

Authors+Show Affiliations

Unité de Traitement de la Douleur de l'Enfant, Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrie, Lyon, France.Department of Medical Oncology, Institut Curie, Paris, France.Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France.Centre Léon Bérard, University Claude Bernard, Lyon, France.Department of Cancer Medicine, Centre Hospitalo-Universitaire, Tours, France.Department of Pediatric and Adolescent Hematology-Oncology, Hôpital Mère-Enfant, Nantes, France.Department of Medical Oncology, Institut de Cancérologie de la Loire, Lucien Neuwirth, St Priest en Jarez, France.Department of Medical Oncology, CHRU Jean Minjoz, Besançon, France.Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France.Department of Medical Oncology, Centre Eugène-Marquis, Rennes, France.Medical Oncology Department, Centre Antoine Lacassagne, Nice, France.Medical Oncology Department, Centre Francois Baclesse, Caen, France.CHU Nantes Hôtel-Dieu/Laboratoire UMR1238 Phyos, Faculté de Médecine de Nantes, Nantes, France.Medical Oncology Department, Centre Henri Becquerel, Rouen, France.R&D Unicancer, Paris, France.Pediatric Oncology Unit-Adolescents and Young Adults, Centre Oscar Lambret, Lille, France.Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France.Biostatistics and Methodology Unit, Institut Gustave Roussy, Villejuif, France.Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France.Department of Medical Oncology, Institut Curie, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31702419

Citation

Marec-Berard, Perrine, et al. "Methotrexate-Etoposide-Ifosfamide Compared With Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years." Journal of Adolescent and Young Adult Oncology, 2019.
Marec-Berard P, Laurence V, Occean BV, et al. Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. J Adolesc Young Adult Oncol. 2019.
Marec-Berard, P., Laurence, V., Occean, B. V., Ray-Coquard, I., Linassier, C., Corradini, N., ... Piperno-Neumann, S. (2019). Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. Journal of Adolescent and Young Adult Oncology, doi:10.1089/jayao.2019.0085.
Marec-Berard P, et al. Methotrexate-Etoposide-Ifosfamide Compared With Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. J Adolesc Young Adult Oncol. 2019 Nov 8; PubMed PMID: 31702419.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. AU - Marec-Berard,Perrine, AU - Laurence,Valérie, AU - Occean,Bob-Valéry, AU - Ray-Coquard,Isabelle, AU - Linassier,Claude, AU - Corradini,Nadège, AU - Collard,Olivier, AU - Chaigneau,Loïc, AU - Cupissol,Didier, AU - Kerbrat,Pierre, AU - Saada-Bouzid,Esma, AU - Delcambre,Corinne, AU - Gouin,François, AU - Guillemet,Cécile, AU - Jimenez,Marta, AU - Lervat,Cyril, AU - Gaspar,Nathalie, AU - Le Deley,Marie-Cécile, AU - Brugieres,Laurence, AU - Piperno-Neumann,Sophie, Y1 - 2019/11/08/ PY - 2019/11/9/entrez KW - chemotherapy KW - clinical trial KW - methotrexate KW - osteosarcoma KW - toxicity JF - Journal of adolescent and young adult oncology JO - J Adolesc Young Adult Oncol N2 - Purpose: The French standard chemotherapy for osteosarcoma combines high-dose methotrexate (HDM) and etoposide-ifosfamide (EI) in children and adolescents, and API-AI (doxorubicin-cisplatin-ifosfamide) in adults. We herein present the results of M-EI and API-AI in 18- to 25-year-old patients. Methods: Patients, 18-25 years old, received either M-EI or API-AI regimens. M-EI comprised seven M and two EI doses preoperatively then M-EI in standard-risk patients (good histological response without metastasis) and five M-AP (methotrexate-doxorubicin-cisplatin) in high-risk patients (poor histological response, metastasis, and/or unresectable primary), postoperatively. API-AI comprised three API and two AI doses preoperatively, then two AI and two PI in standard-risk patients and five EI in high-risk patients, postoperatively. Results: We analyzed 95 patients 18-25 years of age: 55 received M-EI and 40 API-AI. The groups had similar baseline characteristics. Eighty-nine patients (94%) had surgery. Twenty-nine of 55 M-EI patients (60%) and 16/40 API-AI patients (41%) had good histological responses to preoperative chemotherapy. At 5 years, event-free survival was 50% (95% confidence interval [CI]: 39-60) and overall survival was 65% (95% CI: 54-74). Acute toxicity was similar, without treatment-related deaths. Conclusions: Survival outcomes with M-EI and API-AI were not significantly different. Tolerance was acceptable with both regimens. HDM is thus feasible for young adults. However, our study limitations preclude any definitive conclusions. SN - 2156-535X UR - https://www.unboundmedicine.com/medline/citation/31702419/Methotrexate-Etoposide-Ifosfamide_Compared_with_Doxorubicin-Cisplatin-Ifosfamide_Chemotherapy_in_Osteosarcoma_Treatment,_Patients_Aged_18-25_Years L2 - https://www.liebertpub.com/doi/full/10.1089/jayao.2019.0085?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -