What are the NCCN and ESMO guidelines for first-line chemotherapy regimens for osteosarcoma?

Updated: Dec 04, 2018
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

ESMO-PaedCan-EURACAN guidelines note that doxorubicin, cisplatin, high-dose methotrexate, and ifosfamide have antitumor activity in osteosarcoma. In patients older than 40 years, preferred regimens often combine doxorubicin, cisplatin, and ifosfamide without high-dose methotrexate. [31]

For first-line osteosarcoma therapy (primary/neoadjuvant/adjuvant therapy or for metastatic disease), NCCN recommendations are as follows [30] :

  • Cisplatin and doxorubicin (category 1)
  • MAP (high-dose methotrexate, cisplatin, and doxorubicin) (category 1)
  • Doxorubicin, cisplatin, ifosfamide, and high-dose methotrexate
  • Ifosfamide, cisplatin, and epirubicin

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