Osteosarcoma medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Current standard treatment for osteosarcoma is to use neoadjuvant chemotherapy (chemotherapy given before surgery) followed by surgical resection. The most common drugs used to treat osteosarcoma are Cisplatin, doxorubicin and high-dose methotrexate. Ifosfamide can be used as an adjuvant treatment if the necrosis rate is low.

Medical Therapy

• Current standard treatment for osteosarcoma is to use neoadjuvant chemotherapy (chemotherapy given before surgery) followed by surgical resection.
• The percentage of tumor cell necrosis (cell death) seen in the tumor after surgery gives an idea of the prognosis and also lets the oncologist know if the chemotherapy regimen should be altered after surgery.
• The most common chemotherapy combinations used to treat osteosarcoma are:

• Cisplatin, doxorubicin and high-dose methotrexate.
• Cisplatin and doxorubicin.

• Standard therapy is a combination of limb-salvage orthopedic surgery and a combination of high dose methotrexate with leucovorin rescue, intra-arterial cisplatin, caffeine, adriamycin, ifosfamide with mesna, BCD, etoposide, and muramyl tri-peptite (MTP).
• Ifosfamide can be used as an adjuvant treatment if the necrosis rate is low.
• Fluids are given for hydration.
• Drugs like Kytril and Zofran help with nausea and vomiting.
• Neupogen, epogen, Neulasta help with white blood cell counts and neutrophil counts.
• Blood helps with anemia.

Samarium

• Samarium is a radioactive drug that targets areas where bone cells growing, such as tumor cells in the bone.
• It helps relieve pain caused by cancer in the bone and it also kills blood cells in bone marrow.
• Treatment with samarium may be followed by stem cell transplant.
• Before treatment with samarium, stem cells (immature blood cells) are removed from the blood or bonemarrow of the patient and are frozen and stored. After treatment with samarium is complete, the stored stem cells are thawed and given back to the patient through an infusion. These re-infused stem cells grow into (and restore) the body's blood cells.