Comparison of pirarubicin-based versus gemcitabine-docetaxel chemotherapy for relapsed and refractory osteosarcoma: a single institution experience.

Abstract

BACKGROUND:

The prognoses for patients with relapsed and refractory osteosarcoma are poor and the optimal treatment strategy is still to be defined. We conducted this retrospective study to compare the feasibility and efficacy of pirarubicin-based chemotherapy with gemcitabine-docetaxel combination regimens for the salvage of these patients.

METHODS:

The clinical data of 75 patients who received pirarubicin-based (n = 52) or gemcitabine-docetaxel (n = 23) chemotherapy as a second-line treatment for relapsed and refractory osteosarcoma between January 2005 and September 2011were reviewed retrospectively. Tumor response was evaluated every two chemotherapy cycles by computed tomography/magnetic resonance imaging (CT/MRI) scans using the Response Evaluation Criteria in Solid Tumors. Progression-free survival and overall survival (OS) were evaluated by Kaplan-Meier analysis. Toxicity was examined according to the National Cancer Institute Toxicity Criteria grading system.

RESULTS:

Patient characteristics were well balanced in the two groups. The response rate was 25.0 % in patients who received pirarubicin-based chemotherapy, while it was 13.0 % in the gemcitabine-docetaxel group. Moreover, the median OS was longer in the pirarubicin-based chemotherapy group (14.0 vs. 9.0 months, P < 0.05), especially in the pirarubicin-ifosfamide (14.0 months) and pirarubicin-cisplatin (15.0 months) subgroups. The incidence of grade 3-4 neutropenia was higher in the gemcitabine-docetaxel group (5.8 vs. 43.5 %, P < 0.05); other grade 3-4 toxicities were comparable in the two groups.

CONCLUSIONS:

In our experience, pirarubicin-based chemotherapy was comparable with gemcitabine-docetaxel as a second-line treatment for relapsed and refractory osteosarcoma, and it even seemed to show greater efficacy, with milder toxicity. Further studies, especially prospective clinical trials, focusing on pirarubicin-based treatments for relapsed and refractory osteosarcoma patients should be strongly considered.

• Authors: Aina He, Weixiang Qi, Yujing Huang, Yuanjue Sun, Zan Shen, Hui Zhao, Yumei Yang, Yang Yao
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 18 Issue 3 Pg. 498-505 (Jun 2013) ISSN: 1437-7772 [Electronic] Japan
• PMID: 22534798 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Taxoids
• Deoxycytidine
• Docetaxel
• Doxorubicin
• pirarubicin
• Ifosfamide
• Gemcitabine

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols
• Bone Neoplasms (drug therapy, pathology)
• Child
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease-Free Survival
• Docetaxel
• Doxorubicin (administration & dosage, adverse effects, analogs & derivatives)
• Drug-Related Side Effects and Adverse Reactions (classification, pathology)
• Female
• Humans
• Ifosfamide (administration & dosage)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Osteosarcoma (drug therapy, pathology)
• Prospective Studies
• Taxoids (administration & dosage)
• Gemcitabine