What is your preferred next line of therapy for a fit patient with unresectable, refractory osteosarcoma who has progressed after MAP, local radiation, and IE?
Would you consider regorafenib based on the REGOBONE trial? Or would you consider other agents knowing that we do not have positive survival data with other regimens?
Answer from: Medical Oncologist at Academic Institution
This is an excellent and yet difficult question. Sadly there is no clearly preferred treatment after failure of MAP and IE. Do you know what the original response to chemo was? Was there >90% necrosis? Some osteosarcomas are primary chemo resistant, making further salvage chemo unlikely to help. ...
Answer from: Medical Oncologist at Academic Institution
1. Regorafenib is fine to try. Pazopanib has activity too. I give more pazopanib than regorafenib, so I usually reach for pazopanib first.
2. If your patient progressed right thru MAP then there is no reason to go back. But if your patient had primary MAP and now some time later h...