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Sarcoma • Medical Oncology
What is your preferred neoadjuvant chemotherapy course for healthy adult patients with osteosarcoma?
Is there an age limit you use to consider MAP? Would you consider using AIM instead?
Answer from: Medical Oncologist at Academic Institution
This article discusses the safety & efficacy of HDMTX in young adults and shows it can be safely administered, with good supportive care. The EURO-BOSS study is also a great resource for this topic.Because older adults do seem to tolerate HDMTX more poorly and experience markedly delayed clearan...
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Answer from: Medical Oncologist at Academic Institution
In my experience, high-dose methotrexate (12 g/m2) is poorly tolerated in adults over the age of 25 or so. I believe the data favor doxorubicin/cisplatin in the neoadjuvant setting. I am not aware of a benefit to the addition of ifosfamide in the neoadjuvant setting.
Comments
Medical Oncologist at Siri Onclogy and hematology Infusion Service
The removal of methotrexate is definitely associat...
The removal of methotrexate is definitely associat...
Answer from: Medical Oncologist at Academic Institution
We use doxorubicin 75-90 mg/m2 by 72 hr infusion or bolus with dexrazoxane plus cisplatinum 100-120 mg/m2 over 3 hours intra-arterial when possible. Usually 4 cycles then determine postop chemotherapy based on percent necrosis.