Primary metastatic osteosarcoma: results of a prospective study in children given chemotherapy and interleukin-2.

Abstract

To improve the poor prognosis for children with metastatic osteosarcoma (OS), interleukin-2 (IL-2) was added to the standard treatment due to its capacity to activate lymphocytes and differentiate lymphocyte subsets into lymphokine-activated killer (LAK) cells that are capable of recognizing and killing various tumor cells. This study concerns a cohort of unselected patients aged < 18 years with metastatic OS, who were treated with IL-2, high-dose methotrexate, doxorubicin, cisplatin, ifosfamide, LAK reinfusion, and surgery, between 1995 and 2010. Thirty-five patients aged 4-17 years were involved. Thirty-two of the 35 patients underwent surgery on their primary tumor, and 25 had surgery on lung metastases too. Twenty-seven patients received IL-2 plus LAK reinfusion. The median follow-up was 130 months (77-228), and the 3-year event-free and overall survival rates were 34.3 and 45.0%, respectively. Eleven patients remained alive, all of whom achieved a complete surgical removal of the primary tumor and lung metastases (1 patient did not receive lung resections due to complete lung metastases remission). Patients who had a complete surgical remission of the primary and metastatic sites and who responded well to chemotherapy had a better event-free survival. These results confirm the importance of complete surgical remission and point to a noteworthy (though still be ameliorate) survival rate in our series of patients, underling a potential role for immunotherapy with IL-2 and LAK/NK cell activation.

• Authors: Cristina Meazza, Graziella Cefalo, Maura Massimino, Primo Daolio, Ugo Pastorino, Paolo Scanagatta, Carlo Morosi, Marta Podda, Andrea Ferrari, Monica Terenziani, Filippo Spreafico, Michela Casanova, Antonina Parafioriti, Paola Collini, Lorenza Gandola, Stefano Bastoni, Veronica Biassoni, Elisabetta Schiavello, Stefano Chiaravalli, Nadia Puma, Luca Bergamaschi, Roberto Luksch
• Journal: Medical oncology (Northwood, London, England) (Med Oncol) Vol. 34 Issue 12 Pg. 191 (Nov 01 2017) ISSN: 1559-131X [Electronic] United States
• PMID: 29094224 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Interleukin-2
• Doxorubicin
• Cisplatin
• Ifosfamide

Topics

• Adolescent
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Neoplasms (drug therapy, mortality, pathology, therapy)
• Child
• Child, Preschool
• Cisplatin (administration & dosage)
• Doxorubicin (administration & dosage)
• Female
• Humans
• Ifosfamide (administration & dosage)
• Immunotherapy (methods)
• Interleukin-2 (administration & dosage, therapeutic use)
• Lung Neoplasms (drug therapy, secondary)
• Male
• Osteosarcoma (drug therapy, mortality, pathology, therapy)
• Prospective Studies
• Survival Rate