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Poster Discussion – Sarcoma

4087 - EURO-B.O.S.S.: Outcome in rare non-osteosarcoma bone sarcoma

Date

28 Sep 2019

Session

Poster Discussion – Sarcoma

Presenters

Peter Reichardt

Citation

Annals of Oncology (2019) 30 (suppl_5): v683-v709. 10.1093/annonc/mdz283

Authors

P. Reichardt1, K. Sundby Hall2, R. Bertulli3, S.S. Bielack4, A. Comandone5, G. Egerer6, A. Hansmeier7, E. Palmerini8, S. Smeland9, S. Ferrari10

Author affiliations

  • 1 Oncology And Palliative Care, Helios Klinikum Berlin Buch, 13125 - Berlin/DE
  • 2 Oncology, Norwegian Radium Hospital, Oslo University Hospital, 0310 - Oslo/NO
  • 3 Medical Oncology, Adult Mesenchymal Tumor Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale de Tumori, 20133 - Milan/IT
  • 4 Pediatrics 5 (oncology, Hematology, Immunology), Cooperative Osteosarcoma Study Group COSS, Klinikum Stuttgart – Olgahospital, 70174 - Stuttgart/DE
  • 5 Oncologia Medica, Ospedale Humanitas Gradenigo, 10153 - Torino/IT
  • 6 Hematology & Oncology, University Hospital Heidelberg, 69115 - Heidelberg/DE
  • 7 Internal Medicine A(hematology, Oncology, Hemostaseology And Pulmonology), University Hospital of Muenster, 48149 - Muenster/DE
  • 8 Chemotherapy Unit, Istituto Ortopedico Rizzoli, 40136 - Bologna/IT
  • 9 Cancer Medicine, Oslo University Hospital, 0424 - Oslo/NO
  • 10 Chemotherapy, Istituto Ortopedico Rizzoli, 40136 - Bologna/IT

Resources

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Abstract 4087

Background

The EUROpean Bone over 40 Sarcoma Study included patients with 41 to 65 years of age with primary malignant bone sarcoma treated with intensive multiagent chemotherapy. Outcome in the subgroup of high-grade osteosarcoma has been published (Ferrari et al. 2017). This report focuses on other bone sarcomas representing the largest prospectively collected dataset based on an international consortium.

Methods

Chemotherapy was based on doxorubicin, cisplatin, ifosfamide, and methotrexate. Tumors registered as MFH, sarcoma NOS, spindle cell sarcoma or undifferentiated sarcoma were grouped as „undifferentiated pleomorphic sarcoma“. Further histologies included leiomyosarcoma, fibrosarcoma and angiosarcoma.

Results

122 patients with other bone sarcoma were registered into EURO-B.O.S.S. and 113 considered evaluable for analysis. Their median age was 52 years (range: 40-66). Eighty-eight bone sarcomas were grouped as UPS, 20 were leiomyosarcomas, and 5 had other histologies (3 fibrosarcoma, 2 angiosarcoma). Chemotherapy according to the EURO-B.O.S.S. recommendations was initiated in all patients. Surgery was performed for 109/113 tumors, prior to chemotherapy in 13, delayed in 96. A macroscopically complete surgical remission of the primary tumor site was obtained in 106/113. At last follow-up, 70 patients were alive, 62 of these in complete remission and 8 with bone sarcoma. Of 43 patients who had died after a median of 2.1 years (0.15-8.8), 37 were reported to have died of progressive bone sarcoma, 2 of other causes (1 neutropenic sepsis, 1 secondary malignancy (myeloma)) and 4 of unknown causes.Table:

1675PD

n5y-EFSp-value5y-OSp-value
Histology
UPS8844.90%62.40%
Leiomyosarcoma2032.50%0.14652.00%0.710
other5
Site
extremity8349.40%66.90%
non extremity3029.90%0.0146.80%0.002
Primary surgery
yes1325.60%43.00%
no9648.10%0.11265.00%0.042
Response (in 78)
good2671.60%71.50%
poor5238.90%0.00357.40%0.083

Conclusions

Multiagent chemotherapy was feasible in this patient population. Outcome seems comparable to high-grade osteosarcoma with a non-significant trend for UPS over leiomyosarcoma. Favorable outcome was associated with extremity site, secondary surgery after neoadjuvant chemotherapy, and good response to primary chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

COSS, SSG, ISG.

Disclosure

P. Reichardt: Honoraria (institution), Advisory / Consultancy, Research grant / Funding (institution): Novartis; Honoraria (institution), Advisory / Consultancy: Pfizer; Honoraria (institution), Advisory / Consultancy: Bayer; Honoraria (institution), Advisory / Consultancy: PharmaMar; Honoraria (institution), Advisory / Consultancy: Lilly; Advisory / Consultancy: Clinigen; Advisory / Consultancy: Deciphera; Advisory / Consultancy: Roche; Honoraria (institution): Amgen. R. Bertulli: Honoraria (self), Speaker Bureau / Expert testimony: Lilly; Honoraria (self), Speaker Bureau / Expert testimony: Italfarmaco; Honoraria (self), Speaker Bureau / Expert testimony: PharmaMar. All other authors have declared no conflicts of interest.

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