Treatment Options for Second Recurrence of Osteosarcoma

Surgery to remove the tumor and/or chemotherapy.

Chemotherapy or targeted therapy. For more information, see the Chemotherapy and targeted therapy section.

The cooperative German-Austrian-Swiss osteosarcoma study group reported on 249 patients who had a second recurrence of osteosarcoma. The main therapy was repeated surgical resection of recurrent disease.[72]

The cooperative German-Austrian-Swiss osteosarcoma study group reported on 249 patients who had a second recurrence of osteosarcoma. The main therapy was repeated surgical resection of recurrent disease.[72]

Of these patients, 197 died and 37 were alive in CR (24 patients after a third complete response and 13 patients after a fourth or subsequent complete response).

The cooperative German-Austrian-Swiss osteosarcoma study group reported on 249 patients who had a second recurrence of osteosarcoma. The main therapy was repeated surgical resection of recurrent disease.[72]

Fifteen patients who did not achieve surgical remission remained alive, but follow-up for these patients was extremely short.

The Spanish Group for Research on Sarcoma reported the results of a phase II trial of patients with relapsed or refractory osteosarcoma who were treated with gemcitabine and sirolimus.[73][Level of evidence C3]

The Spanish Group for Research on Sarcoma reported the results of a phase II trial of patients with relapsed or refractory osteosarcoma who were treated with gemcitabine and sirolimus.[73][Level of evidence C3]

The PFS rate at 4 months was 44%.

The Spanish Group for Research on Sarcoma reported the results of a phase II trial of patients with relapsed or refractory osteosarcoma who were treated with gemcitabine and sirolimus.[73][Level of evidence C3]

After central radiological review of 33 assessable patients, 2 partial responses and 14 disease stabilizations (48.5%) were reported.

The COG reported the outcomes of patients with recurrent osteosarcoma from seven phase II trials, all of which were assessed to have shown no treatment benefit.[15]

The COG reported the outcomes of patients with recurrent osteosarcoma from seven phase II trials, all of which were assessed to have shown no treatment benefit.[15]

The EFS rate for 96 patients with osteosarcoma and measurable disease was 12% at 4 months (95% CI, 6%–19%).

The COG reported the outcomes of patients with recurrent osteosarcoma from seven phase II trials, all of which were assessed to have shown no treatment benefit.[15]

There was no significant difference in EFS between the trials according to the number of previous treatment regimens or patient age, sex, and ethnicity.

One additional phase II trial with a different study design was reported. In this trial, patients with osteosarcoma and metastases to the lung underwent surgical resection of all lung nodules and then were treated with adjuvant inhaled GM-CSF.[15]

One additional phase II trial with a different study design was reported. In this trial, patients with osteosarcoma and metastases to the lung underwent surgical resection of all lung nodules and then were treated with adjuvant inhaled GM-CSF.[15]

The 12-month EFS rate for the 42 evaluable patients enrolled in this study was 20% (95% CI, 10%–34%).