TITLE:
Cyclophosphamide and Etoposide as a Salvage Treatment in Metastatic Osteosarcoma Patients
AUTHORS:
Fatma MF Akl, Mohamed Farouk Akl
KEYWORDS:
Cyclophosphamide, Etoposide, Metastatic Osteosarcoma, Salvage Chemotherapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.7,
July
9,
2018
ABSTRACT: Background and Objective: Osteosarcoma is a
rare bone cancer with approximately 30% - 35% of patients who will relapse
either systemically or locally, with the lung being the commonest site of
relapse. The objective of this trial was to evaluate the efficacy of
cyclophosphamide and etoposide, in treatment of metastatic osteosarcoma
patients progressed after one or more chemotherapy lines, with the progression
free survival and treatment response as the primary endpoints, while the
secondary endpoints were overall survival and treatment toxicity. Patients and
Methods: Twenty seven metastatic osteosarcoma patients were enrolled into this
trial and received cyclophosphamide and etoposide chemotherapy.
Cyclophosphamide was given at a dose of 500 mg/m2 per day, I.V for 5 days and
etoposide (100 mg/m2 per day I.V for 5 days). Response was assessed after 3
cycles according to Response Evaluation Criteria in Solid Tumors (RECIST)
version 1.1. Chemotherapy Toxicity was graded according to the Common
Terminology Criteria for Adverse Events (CTCAE). Results: The median overall
survival time and progression-free survival were 12 months and 8 months,
respectively. Four patients (14.8%) achieved partial response; 14 patients
(51.9%) had stationary disease (SD); and 9 (33.3%) expressed tumor progression.
Hematologic toxicity was the main toxicity. None of the patients had G4 or life
threatening toxicities. Conclusion: The combination of cyclophosphamide and
etoposide represents an efficient and tolerable treatment option for patients
with metastatic osteosarcoma.