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 Tunn & 13 others Nina 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

Abstract

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. 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. 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. 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 languageUndefined/Unknown
Pages (from-to)30-36
Number of pages7
JournalTumori
Volume104
DOIs
Publication statusPublished - 2018

Keywords

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols, adverse effects, therapeutic use
  • Bone Neoplasms, drug therapy, pathology
  • Cisplatin, administration & dosage, adverse effects
  • Doxorubicin, administration & dosage, adverse effects
  • Europe
  • Febrile Neutropenia, chemically induced
  • Female
  • Humans
  • Ifosfamide, administration & dosage, adverse effects
  • International Cooperation
  • Male
  • Methotrexate, administration & dosage, adverse effects
  • Middle Aged
  • Osteosarcoma, drug therapy, pathology
  • Prospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Adult osteosarcoma
  • Chemotherapy
  • Chemotherapy-related toxicity
  • Osteosarcoma

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, 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, 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, P-U, Jebsen, NL, Cesari, M, von Kalle, T, Ferraresi, V, Schwarz, R, Bertulli, R, Kasparek, A-K, 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, 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. pp. 30-36.
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title = "EURO-B.O.S.S.: A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma.",
abstract = "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. 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. 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. 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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author = "Stefano Ferrari and Bielack, {Stefan S} and Sigbj{\o}rn Smeland and Alessandra Longhi and Gerlinde Egerer and {Sundby Hall}, Kirsten and Davide Donati and Matthias Kevric and Otte Brosj{\"o} and Alessandro Comandone and Mathias Werner and Odd Monge and Emanuela Palmerini and Berdel, {Wolfgang E} and Bodil Bjerkehagen and Anna Paioli and Sylvie Lorenzen and Mikael Eriksson and Marco Gambarotti and Per-Ulf Tunn and Jebsen, {Nina L} and Marilena Cesari and {von Kalle}, Thekla and Virginia Ferraresi and Rudolf Schwarz and Rossella Bertulli and Anne-Katrin Kasparek and Giovanni Grignani and Fatime Krasniqi and Benjamin Sorg and Stefanie Hecker-Nolting and Piero Picci and Peter Reichardt",
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TY - JOUR

T1 - EURO-B.O.S.S.: 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

Y1 - 2018

N2 - 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. 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. 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. 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 - 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. 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. 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. 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

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols, adverse effects, therapeutic use

KW - Bone Neoplasms, drug therapy, pathology

KW - Cisplatin, administration & dosage, adverse effects

KW - Doxorubicin, administration & dosage, adverse effects

KW - Europe

KW - Febrile Neutropenia, chemically induced

KW - Female

KW - Humans

KW - Ifosfamide, administration & dosage, adverse effects

KW - International Cooperation

KW - Male

KW - Methotrexate, administration & dosage, adverse effects

KW - Middle Aged

KW - Osteosarcoma, drug therapy, pathology

KW - Prospective Studies

KW - Survival Analysis

KW - Treatment Outcome

KW - Adult osteosarcoma

KW - Chemotherapy

KW - Chemotherapy-related toxicity

KW - Osteosarcoma

U2 - 10.5301/tj.5000696

DO - 10.5301/tj.5000696

M3 - Articolo

VL - 104

SP - 30

EP - 36

JO - Tumori

JF - Tumori

SN - 0300-8916

ER -