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Combination Chemotherapy Before and After Surgery in Treating Patients With Osteosarcoma

This study has been terminated.
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: July 11, 2001
Last updated: June 4, 2015
Last verified: October 2007

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving chemotherapy before surgery may shrink the tumor so that it can be removed during surgery. Giving chemotherapy after surgery may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving chemotherapy before and after surgery works in treating patients with osteosarcoma.

Condition Intervention Phase
Cardiac Toxicity
Biological: filgrastim
Drug: cisplatin
Drug: dexrazoxane hydrochloride
Drug: doxorubicin hydrochloride
Drug: leucovorin calcium
Drug: methotrexate
Procedure: adjuvant therapy
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: Osteosarcoma: Outcome of Therapy Based on Histologic Response. A Collaborative Effort of the POB/NCI, Texas Children's Hospital and University of Oklahoma.

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Rate of in vivo histologic response
  • Event-free survival
  • Overall survival

Estimated Enrollment: 100
Study Start Date: March 2000
Study Completion Date: October 2011
Primary Completion Date: December 2006 (Final data collection date for primary outcome measure)
Detailed Description:


  • Determine the rate of in vivo histologic response in patients with osteosarcoma treated with neoadjuvant cisplatin, methotrexate, and doxorubicin with dexrazoxane (as cardioprotection).
  • Determine the event-free and overall survival of patients with nonmetastatic disease who show good response to neoadjuvant therapy and receive adjuvant therapy with the same regimen.
  • Determine the event-free survival of patients with nonmetastatic disease who show poor response to neoadjuvant therapy and receive adjuvant therapy with the same regimen.
  • Determine the event-free survival and overall survival of patients with metastatic disease who receive neoadjuvant therapy.

OUTLINE: This is a multicenter study.

  • Neoadjuvant therapy: Patients receive neoadjuvant chemotherapy comprising dexrazoxane IV over 15 minutes, doxorubicin IV over 15 minutes, and cisplatin IV over 4 hours on days 1 and 2 in week 0. Patients also receive methotrexate IV over 4 hours followed by leucovorin calcium in weeks 3 and 4. Patients then receive filgrastim (G-CSF) subcutaneously (SC) once daily beginning 24 hours after completion of chemotherapy and continuing until blood counts recover. Treatment repeats every 5 weeks for 2 courses in the absence of disease progression or unacceptable toxicity.
  • Surgical resection: Patients undergo definitive surgery in week 11.
  • Adjuvant therapy: Patients receive dexrazoxane, doxorubicin, cisplatin, methotrexate, and leucovorin calcium as in neoadjuvant therapy*. Treatment repeats every 5 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

NOTE: *Cisplatin is not administered in courses 3 and 4 of adjuvant therapy

Patients are followed within 4 weeks, every 3 months for 2 years, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: Approximately 100 patients will be accrued for this study.


Ages Eligible for Study:   up to 25 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed newly diagnosed osteosarcoma

    • No more than 1 month since prior diagnostic biopsy
    • Nonmetastatic malignant high-grade osteosarcoma of bone
    • Histologically confirmed metastatic disease allowed
    • Unresectable primary disease allowed
  • No low-grade, parosteal, or periosteal osteosarcoma



  • 25 and under

Performance status:

  • Not specified

Life expectancy:

  • Not specified


  • Absolute neutrophil count at least 1,000/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 8.0 g/dL


  • Bilirubin no greater than 2.0 mg/dL
  • ALT less than 5 times normal


  • Creatinine no greater than 1.5 times normal
  • Creatinine clearance or radioisotope glomerular filtration rate greater than 70 mL/min


  • Shortening fraction at least 27% by echocardiogram or MUGA
  • Ejection fraction at least 45% by echocardiogram or MUGA


  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after study


Biologic therapy:

  • Not specified


  • See Disease Characteristics
  • No other concurrent chemotherapy

Endocrine therapy:

  • Not specified


  • See Disease Characteristics


  • Not specified


  • No other concurrent therapy with no evidence of progressive disease
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00019864

United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
United States, Oklahoma
Oklahoma University Cancer Institute
Oklahoma City, Oklahoma, United States, 73104
United States, Texas
Cook Children's Medical Center - Fort Worth
Fort Worth, Texas, United States, 76104
Texas Children's Cancer Center and Hematology Service at Texas Children's Hospital
Houston, Texas, United States, 77030-2399
Sponsors and Collaborators
National Cancer Institute (NCI)
Study Chair: Ramzi Dagher, MD National Cancer Institute (NCI)
  More Information Identifier: NCT00019864     History of Changes
Obsolete Identifiers: NCT00001821
Other Study ID Numbers: CDR0000067263
Study First Received: July 11, 2001
Last Updated: June 4, 2015

Keywords provided by National Cancer Institute (NCI):
cardiac toxicity
localized osteosarcoma
metastatic osteosarcoma
recurrent osteosarcoma

Additional relevant MeSH terms:
Neoplasms, Bone Tissue
Neoplasms, Connective Tissue
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Pathologic Processes
Drug-Related Side Effects and Adverse Reactions
Chemically-Induced Disorders
Radiation Injuries
Wounds and Injuries
Liposomal doxorubicin
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Physiological Effects of Drugs
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Dermatologic Agents
Enzyme Inhibitors
Folic Acid Antagonists processed this record on April 21, 2017