Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone

• Published in: BMC cancer Vol. 16; no. 279; p. 280
• Main Authors: Palmerini, E, Jones, R L, Marchesi, E, Paioli, A, Cesari, M, Longhi, A, Meazza, C, Coccoli, L, Fagioli, F, Asaftei, S, Grignani, G, Tamburini, A, Pollack, S M, Picci, P, Ferrari, S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.04.2016; BioMed Central
• Subjects: Adolescent; Adult; Aged; Care and treatment; Child; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Docetaxel; Dosage and administration; Female; Gemcitabine; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - pathology; Osteosarcoma; Osteosarcoma - drug therapy; Osteosarcoma - pathology; Recurrence; Sarcoma; Sarcoma - drug therapy; Sarcoma - pathology; Taxoids - administration & dosage; Treatment Outcome; Chemotherapy; Gemcitabine; Osteosarcoma; Docetaxel; High-grade bone sarcoma
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-016-2312-3

Few new compounds are available for relapsed osteosarcoma. We retrospectively evaluated the activity of gemcitabine (G) plus docetaxel (D) in patients with relapsed high-grade osteosarcoma and high-grade spindle cell sarcoma of bone (HGS). Patients receiving G 900 mg/m(2) d 1, 8; D 75 mg/m(2) d 8, every 21 days were eligible. Primary end-point: progression-free survival (PFS) at 4 months; secondary end-point: overall survival (OS) and response rate. Fifty-one patients were included, with a median age of 17 years (8-71), 26 (51%) were pediatric patients. GD line of treatment: 2nd in 14 patients, ≥3rd in 37. 25 (49%) patients had metastases limited to lungs, 26 (51%) multiple sites. 40 (78%) osteosarcoma, 11 (22%) HGS. Eight (16%) patients achieved surgical complete response (sCR2) after GD. Four-month PFS rate was 46%, and significantly better for patients with ECOG 0 (ECOG 0: 54% vs ECOG 1: 43% vs ECOG 2: 0%; p = 0.003), for patients undergoing metastasectomy after GD (sCR2 75% vs no-sCR2 40 %, p = 0.02) and for osteosarcoma (osteosarcoma 56% vs HGS 18%; p = 0.05), with no differences according to age, line of treatment, and pattern of metastases. Forty-six cases had RECIST measurable disease: 6 (13%) patients had a partial response (PR), 20 (43%) had stable disease (SD) and 20 (43%) had progressive disease (PD). The 1-year OS was 30%: 67% for PR, 54% for SD and 20% for PD (p = 0.005). GD is an active treatment for relapsed high-grade osteosarcoma, especially for ECOG 0 patients, and should be included in the therapeutic armamentarium of metastatic osteosarcoma.