Addition of pamidronate to chemotherapy for the treatment of osteosarcoma.

Abstract

BACKGROUND:

This study evaluated the safety and feasibility of the addition of pamidronate to chemotherapy for treatment of osteosarcoma.

METHODS:

The authors treated 40 patients with osteosarcoma with cisplatin, doxorubicin, and methotrexate with the addition of pamidronate 2 mg/kg/dose (max dose 90 mg) monthly for 12 doses. Survival, event-free survival (EFS), and durability of orthopedic reconstruction were evaluated.

RESULTS:

For patients with localized disease, event-free survival (EFS) at 5 years was 72% and overall survival 93%. For patients with metastatic disease, EFS at 5 years was 45% and overall survival 64%. Toxicity was similar to patients treated with chemotherapy alone. Thirteen of 14 uncemented implants demonstrated successful osteointegration. Among allograft reconstructions, there were 2 graft failures, 4 delayed unions, and 6 successful grafts. Overall, 5 of 33 reconstructions failed. There were no stress fractures or growth disturbances.

CONCLUSIONS:

Pamidronate can be safely incorporated with chemotherapy for the treatment of osteosarcoma. It does not impair the efficacy of chemotherapy. Pamidronate may improve the durability of limb reconstruction.

• Authors: Paul A Meyers, John H Healey, Alexander J Chou, Leonard H Wexler, Pamela R Merola, Carol D Morris, Michael P Laquaglia, Michael G Kellick, Sara J Abramson, Richard Gorlick
• Journal: Cancer (Cancer) Vol. 117 Issue 8 Pg. 1736-44 (Apr 15 2011) ISSN: 0008-543X [Print] United States
• PMID: 21472721 (Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2010 American Cancer Society.

Chemical References

• Diphosphonates
• Doxorubicin
• Pamidronate
• Cisplatin
• Methotrexate

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Neoplasms (drug therapy)
• Cisplatin (administration & dosage)
• Diphosphonates (administration & dosage, adverse effects)
• Doxorubicin (administration & dosage)
• Drug Administration Schedule
• Feasibility Studies
• Female
• Humans
• Male
• Methotrexate (administration & dosage)
• Osteosarcoma (drug therapy)
• Pamidronate