Pirarubicin versus doxorubicin in neoadjuvant/adjuvant chemotherapy for stage IIB limb high-grade osteosarcoma: does the analog matter?

Abstract

Pirarubicin (THP), a novel anthracycline derivative of doxorubicin (ADM), is effective in treating patients with advanced, relapsed or recurrent high-grade osteosarcoma. But its role in neoadjuvant/adjuvant chemotherapy of osteosarcoma is still not defined. We conducted a retrospective evaluation of THP-containing chemotherapy for osteosarcoma in comparison with ADM-containing chemotherapy to determine differences in efficacy and toxicities between THP- and ADM-containing regimens. From January 2008 to May 2011, 112 stage IIB limb high-grade osteosarcoma patients were treated in our institute. Fifty-four patients received a median 6 cycles of neoadjuvant/adjuvant chemotherapy consisted of THP (pirarubicin), DDP (cisplatin), IFO (ifosfamide) and MTX (methotrexate), while 58 patients received a median 6 cycles of neoadjuvant/adjuvant chemotherapy consisted of ADM (doxorubicin), DDP (cisplatin), IFO (ifosfamide) and MTX (methotrexate). Efficacy and toxicity of the 2 anthracyclines given as combination chemotherapy were assessed in these patients. The limb salvage rate, histologic response rate, 2-year recurrence rate, 2-year metastasis rate, 2-year disease-free survival rate, 2-year overall survival rate, median disease-free survival time (DFS) and median overall survival time (OS) in THP-containing group were similar to that in ADM-containing group. Toxicities were well balanced in two groups. No death related to chemotherapy was observed. Left ventricular ejection fraction was unchanged 1 and 2 years after chemotherapy in two groups. Efficacy and toxicity of THP-containing combination are similar to those of ADM-containing combination in neoadjuvant/adjuvant chemotherapy for stage IIB limb high-grade osteosarcoma.

• Authors: Wenxi Yu, Lina Tang, Feng Lin, Yang Yao, Zan Shen
• Journal: Medical oncology (Northwood, London, England) (Med Oncol) Vol. 32 Issue 1 Pg. 307 (Jan 2015) ISSN: 1559-131X [Electronic] United States
• PMID: 25432694 (Publication Type: Journal Article)

Chemical References

• Doxorubicin
• pirarubicin
• Cisplatin
• Ifosfamide
• Methotrexate

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Neoplasms (drug therapy, mortality)
• Chemotherapy, Adjuvant (methods)
• Child
• Cisplatin (therapeutic use)
• Disease-Free Survival
• Doxorubicin (analogs & derivatives, therapeutic use)
• Extremities
• Female
• Humans
• Ifosfamide (therapeutic use)
• Kaplan-Meier Estimate
• Male
• Methotrexate (therapeutic use)
• Middle Aged
• Neoadjuvant Therapy (methods)
• Neoplasm Grading
• Neoplasm Staging
• Osteosarcoma (drug therapy, mortality)
• Retrospective Studies
• Young Adult