Prolonged 14-day continuous infusion of high-dose ifosfamide for patients with relapsed and refractory high-grade osteosarcoma: a retrospective multicentre cohort study

Elisa Tirtei ^1,2, Anna Campello ³, Veronica Sciannameo ⁴

¹Paediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Piazza Polonia 94, Turin, 10126, Italy.
²Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
³Paediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Piazza Polonia 94, Turin, 10126, Italy. anna.campello@unito.it.
⁴Centre for Biostatistics, Epidemiology and Public Health, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, 10043, Italy. veronica.sciannameo@unito.it.
⁵Paediatric Oncology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
⁶Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
⁷Department of Paediatric Haematology-Oncology, Meyer Children's Hospital IRCCS, Florence, Italy.
⁸Pediatric Oncology-Hematology Unit, Stem Cell Transplantation and EURACAN Hub Center Unit, S. Chiara Hospital, AOUP, Pisa, Italy.
⁹Paediatrics Division, Department of Health Sciences, AOU Maggiore della Carità di Novara, Piemonte Orientale University, Novara, Italy.
¹⁰Centre for Biostatistics, Epidemiology and Public Health, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, 10043, Italy.

⁰Paediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Piazza Polonia 94, Turin, 10126, Italy.

Bmc Cancer +

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June 19, 2024

View abstract on PubMed

Summary

High-dose Ifosfamide (14-IFO) shows promise for relapsed/refractory osteosarcoma (R/R OS). This outpatient treatment offers a tolerable toxicity profile and potential for home administration, improving patient quality of life.

Area Of Science

Medical Oncology
Clinical Pharmacology
Cancer Therapeutics

Background

Prognosis for relapsed/refractory osteosarcoma (R/R OS) is poor, with limited systemic therapy options.
High-dose Ifosfamide (14 g/sqm) via external pump in an outpatient setting (14-IFO) for R/R OS is underutilized.
This study is the first retrospective analysis of 14-IFO's efficacy and safety in R/R OS patients.

Purpose Of The Study

To evaluate the anti-tumour activity of 14-IFO in R/R OS patients.
To assess the toxicity profile of 14-IFO in this patient population.
To determine survival outcomes associated with 14-IFO treatment.

Main Methods

Retrospective cohort analysis of 26 R/R OS patients treated with 14-IFO.
Tumour response assessed using RECIST 1.1 criteria.
Survival rates and toxicity evaluated using CTCAE v.5 criteria.

Main Results

Overall Response Rate (ORR) was 23%, and Disease Control Rate (DCR) was 57.5%.
Relapsed OS patients showed higher ORR (45%) and DCR (82%) than refractory patients.
Median Overall Survival (OSurv) was 13.7 months; 1-year OSurv was 51%. Tolerable toxicity profile observed.

Conclusions

14-IFO is a viable treatment option for R/R OS, especially for relapsed cases.
The outpatient administration and tolerable toxicity profile enhance patient quality of life.
14-IFO facilitates subsequent local treatments in a subset of patients.

Keywords:

Chemotherapy Ifosfamide Osteosarcoma Relapse