153Samarium-EDTMP administration followed by hematopoietic stem cell support for bone metastases in osteosarcoma patients.

Abstract

BACKGROUND:

Bone metastatic patients with osteosarcoma have a very poor prognosis. Targeted radiation therapy has been pursued as a valid alternative. The primary end point of this study was progression-free survival (PFS) at 4 months.

PATIENTS AND METHODS:

Twenty-two osteosarcoma patients were treated with Samarium-153 ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP) at various dosages. Administered activities ranged from 150 (3 mCi/kg) to 1140 MBq/kg (30 mCi/kg). Autologous hematopoietic stem cell infusion was carried out on day 14 after the (153)Sm-EDTMP infusion.

RESULTS:

The median PFS was 61 days (18-436 days) and the median overall survival (OS) was 189 days (31-1175 days). PFS and OS for the entire patient population were 32% [95% confidence interval (CI) 16-50] and 76% (95% CI 52-89) at 4 months, respectively. No statistical differences emerged according to 153Sm-EDTMP administered or 24-h retained activity. One-month pain palliation was only observed in a minority of subjects and in none at 4 months.

CONCLUSIONS:

Based on our series, the PFS is dramatically short even when higher activity of (153)Sm-EDTMP is administered. This would mean that, even at high level, 153Sm-EDTMP is itself ineffective against relapsed osteosarcoma or the residual activity is too low to be active on these particular subsets of patients.

• Authors: M Berger, G Grignani, A Giostra, S Ferrari, V Ferraresi, A Tamburini, G Cefalo, F Carnevale-Schianca, E Vassallo, P Picci, M Pagano, M Aglietta, R E Pellerito, F Fagioli
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 23 Issue 7 Pg. 1899-905 (Jul 2012) ISSN: 1569-8041 [Electronic] England
• PMID: 22104576 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Organometallic Compounds
• Organophosphorus Compounds
• Radiopharmaceuticals
• samarium Sm-153 lexidronam

Topics

• Adolescent
• Adult
• Bone Neoplasms (mortality, pathology, therapy)
• Child
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Kaplan-Meier Estimate
• Male
• Organometallic Compounds (administration & dosage, adverse effects, pharmacokinetics)
• Organophosphorus Compounds (administration & dosage, adverse effects, pharmacokinetics)
• Osteosarcoma (mortality, secondary, therapy)
• Radiation Dosage
• Radiopharmaceuticals (administration & dosage, adverse effects, pharmacokinetics)
• Retrospective Studies
• Treatment Outcome
• Young Adult