ABCB1/P-glycoprotein Expression Influence on Non-metastatic Osteosarcoma of the Extremities

  • STATUS
    Recruiting
  • participants needed
    125
  • sponsor
    Grupo Espanol de Investigacion en Sarcomas
Updated on 19 February 2024
methotrexate
metastasis
ejection fraction
adjuvant therapy
ifosfamide
adriamycin
localized disease
p-glycoprotein
glycoprotein
metastatic osteosarcoma
tumor necrosis

Summary

Post-authorization, observational, multicenter and prospective study in patients between 2 and 30 years old diagnosed with non-metastatic high-grade osteosarcoma of the extremities.

All patients included in the study will receive the initial neoadjuvant treatment prescribed by the doctor of each center, according to standard practice (involving methotrexate, cisplatin, and adriamycin). This initial treatment precedes surgical treatment.

After surgical treatment, the histological response to neoadjuvant chemotherapy will be evaluated. The histological response to primary chemotherapy will be expressed as a percentage of tumor necrosis. In the case of tumor necrosis above 90% the patient is defined as a "good responder" in case of a lower percentage as a "poor responder".

As an adjuvant treatment, the following options may be given according to standard practice in each center:

  1. - If there is overexpression of ABCB1 / P-glycoprotein and poor response to induction treatment, in many sites ifosfamide at high doses and MTP-PE, is incorporated in addition to adriamycin.
  2. - If there is overexpression of ABCB1 / P-glycoprotein and a good response to induction treatment, in many centers the option of additional administration of methotrexate, CDDP and adriamycin will be chosen.
  3. - If there is no overexpression of ABCB1 / P-glycoprotein, the administration of methotrexate, adriamycin and cisplatin will be chosen in many sites.

In some sites they will consider the non-administration of MTP-PE or the non-administration of high doses of ifosfamide. And, in some hospitals, they will consider administering MTP-PE to all patients.

Description

The Primary objective is:

  • Disease-free survival measured as a 5-year rate in patients with localized osteosarcoma treated, according to standard practice, with all the drugs currently registered for the treatment of non-metastatic osteosarcoma (methotrexate, cisplatin, adriamycin, ifosfamide, MTP-PE), according to ABCB1 / P-glycoprotein expression.

The Secondary objectives are:

  • Evaluate overall survival in a homogeneous population of patients with non-metastatic osteosarcoma.
  • Disease-free survival at 2 and 3 years.

Details
Condition Osteosarcoma, Osteosarcoma, Sarcoma, Sarcoma
Age 12years - 30years
Clinical Study IdentifierNCT04383288
SponsorGrupo Espanol de Investigacion en Sarcomas
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Confirmed histological diagnosis of high-grade osteosarcoma of the extremities
Age: from 2 to 30 years old
Localized disease (metastasis skip accepted)
Normal liver, kidney and spinal function
Ventricular ejection fraction of 50%
Absence of previous surgical treatments or chemotherapy for osteosarcoma
Interval between histological diagnosis and initiation of chemotherapy not exceeding 4 weeks
Signing of the consent form to participate in the study

Exclusion Criteria

Presence of lung metastases on chest CT or in other locations
Parosteal, periosteal, or secondary osteosarcoma
Contraindications of the medications prescribed in the protocol
Pregnant or lactating
Mental or social conditions that do not guarantee adequate adherence to the protocol
Not having an adequate understanding of study participation
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