EURO-B.O.S.S. A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma

Stefano Ferrari, Stefan S. Bielack, Sigbjørn Smeland, Alessandra Longhi, Gerlinde Egerer, Kirsten Sundby Hall, Davide Donati, Matthias Kevric, Otte Brosjö, Alessandro Comandone, Mathias Werner, Odd Monge, Emanuela Palmerini, Wolfgang E. Berdel, Bodil Bjerkehagen, Anna Paioli, Sylvie Lorenzen, Mikael Eriksson, Marco Gambarotti, Per Ulf TunnNina L. Jebsen, Marilena Cesari, Thekla von Kalle, Virginia Ferraresi, Rudolf Schwarz, Rossella Bertulli, Anne Katrin Kasparek, Giovanni Grignani, Fatime Krasniqi, Benjamin Sorg, Stefanie Hecker-Nolting, Piero Picci, Peter Reichardt

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.

METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.

RESULTS: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.

CONCLUSIONS: In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.

Original languageEnglish
Pages (from-to)30-36
Number of pages7
JournalTumori
Volume104
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Osteosarcoma
Sarcoma
Bone and Bones
Drug Therapy
Methotrexate
Survival
Ifosfamide
Poisons
Doxorubicin
Cisplatin
Neoplasms
Fever
Necrosis
Extremities
Research Personnel
Prospective Studies
Neoplasm Metastasis

Keywords

  • Adult osteosarcoma
  • Chemotherapy
  • Chemotherapy-related toxicity
  • Osteosarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ferrari, S., Bielack, S. S., Smeland, S., Longhi, A., Egerer, G., Sundby Hall, K., ... Reichardt, P. (2018). EURO-B.O.S.S. A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma. Tumori, 104(1), 30-36. https://doi.org/10.5301/tj.5000696

EURO-B.O.S.S. A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma. / Ferrari, Stefano; Bielack, Stefan S.; Smeland, Sigbjørn; Longhi, Alessandra; Egerer, Gerlinde; Sundby Hall, Kirsten; Donati, Davide; Kevric, Matthias; Brosjö, Otte; Comandone, Alessandro; Werner, Mathias; Monge, Odd; Palmerini, Emanuela; Berdel, Wolfgang E.; Bjerkehagen, Bodil; Paioli, Anna; Lorenzen, Sylvie; Eriksson, Mikael; Gambarotti, Marco; Tunn, Per Ulf; Jebsen, Nina L.; Cesari, Marilena; von Kalle, Thekla; Ferraresi, Virginia; Schwarz, Rudolf; Bertulli, Rossella; Kasparek, Anne Katrin; Grignani, Giovanni; Krasniqi, Fatime; Sorg, Benjamin; Hecker-Nolting, Stefanie; Picci, Piero; Reichardt, Peter.

In: Tumori, Vol. 104, No. 1, 01.01.2018, p. 30-36.

Research output: Contribution to journalArticle

Ferrari, S, Bielack, SS, Smeland, S, Longhi, A, Egerer, G, Sundby Hall, K, Donati, D, Kevric, M, Brosjö, O, Comandone, A, Werner, M, Monge, O, Palmerini, E, Berdel, WE, Bjerkehagen, B, Paioli, A, Lorenzen, S, Eriksson, M, Gambarotti, M, Tunn, PU, Jebsen, NL, Cesari, M, von Kalle, T, Ferraresi, V, Schwarz, R, Bertulli, R, Kasparek, AK, Grignani, G, Krasniqi, F, Sorg, B, Hecker-Nolting, S, Picci, P & Reichardt, P 2018, 'EURO-B.O.S.S. A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma', Tumori, vol. 104, no. 1, pp. 30-36. https://doi.org/10.5301/tj.5000696
Ferrari, Stefano ; Bielack, Stefan S. ; Smeland, Sigbjørn ; Longhi, Alessandra ; Egerer, Gerlinde ; Sundby Hall, Kirsten ; Donati, Davide ; Kevric, Matthias ; Brosjö, Otte ; Comandone, Alessandro ; Werner, Mathias ; Monge, Odd ; Palmerini, Emanuela ; Berdel, Wolfgang E. ; Bjerkehagen, Bodil ; Paioli, Anna ; Lorenzen, Sylvie ; Eriksson, Mikael ; Gambarotti, Marco ; Tunn, Per Ulf ; Jebsen, Nina L. ; Cesari, Marilena ; von Kalle, Thekla ; Ferraresi, Virginia ; Schwarz, Rudolf ; Bertulli, Rossella ; Kasparek, Anne Katrin ; Grignani, Giovanni ; Krasniqi, Fatime ; Sorg, Benjamin ; Hecker-Nolting, Stefanie ; Picci, Piero ; Reichardt, Peter. / EURO-B.O.S.S. A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma. In: Tumori. 2018 ; Vol. 104, No. 1. pp. 30-36.
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abstract = "INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.RESULTS: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66{\%} in patients with localized disease and 22{\%} in case of synchronous metastases. The 5-year OS in patients with localized disease was 29{\%} in pelvic tumors, and 70{\%} and 73{\%} for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90{\%} was reported in 21{\%} of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32{\%} of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28{\%} and 24{\%}, respectively. After methotrexate, 23{\%} of patients experienced delayed excretion, in 4 cases with nephrotoxicity.CONCLUSIONS: In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.",
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T1 - EURO-B.O.S.S.

T2 - A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma

AU - Ferrari, Stefano

AU - Bielack, Stefan S.

AU - Smeland, Sigbjørn

AU - Longhi, Alessandra

AU - Egerer, Gerlinde

AU - Sundby Hall, Kirsten

AU - Donati, Davide

AU - Kevric, Matthias

AU - Brosjö, Otte

AU - Comandone, Alessandro

AU - Werner, Mathias

AU - Monge, Odd

AU - Palmerini, Emanuela

AU - Berdel, Wolfgang E.

AU - Bjerkehagen, Bodil

AU - Paioli, Anna

AU - Lorenzen, Sylvie

AU - Eriksson, Mikael

AU - Gambarotti, Marco

AU - Tunn, Per Ulf

AU - Jebsen, Nina L.

AU - Cesari, Marilena

AU - von Kalle, Thekla

AU - Ferraresi, Virginia

AU - Schwarz, Rudolf

AU - Bertulli, Rossella

AU - Kasparek, Anne Katrin

AU - Grignani, Giovanni

AU - Krasniqi, Fatime

AU - Sorg, Benjamin

AU - Hecker-Nolting, Stefanie

AU - Picci, Piero

AU - Reichardt, Peter

PY - 2018/1/1

Y1 - 2018/1/1

N2 - INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.RESULTS: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.CONCLUSIONS: In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.

AB - INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma.METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study.RESULTS: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.CONCLUSIONS: In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.

KW - Adult osteosarcoma

KW - Chemotherapy

KW - Chemotherapy-related toxicity

KW - Osteosarcoma

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