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Sarcoma • Medical Oncology
In a patient who experienced less than 90% necrosis after neoadjuvant chemotherapy for localized, high-grade osteosarcoma, do you recommend adjuvant ifosfamide?
Osteosarcoma conventional type of the distal right femur. cT1N0M0 G3 Stage IIA on MAP protocol completed NACT followed by surgery on radical resection of the tumor femur and knee, followed by reconstruction and prosthesis, resection of skip lesion 18 cm prox to the joint line. pT3NXMX high grade G3 poorly differentiated tumor, 7.5 cm, necrosis 70% + soft tissue extension, margins negative, closest margin 0.1 cm to soft tissue, mitotic rate 1/10HPF.
Answer from: Medical Oncologist at Academic Institution
This patient is correctly identified as poor risk, with an additional skip lesion and necrosis <90%. Early data showed that the addition of ifosfamide to MAP in the adjuvant setting was beneficial. However, the EURAMOS-1 trial formally tested this in a randomized fashion. Patients who had <90%...
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