Other chemotherapy approaches not considered effective

The Italian Sarcoma Group and the Scandinavian Sarcoma Group performed a clinical trial in patients with osteosarcoma who presented with clinically detectable metastatic disease.[42] Consolidation with high-dose etoposide and carboplatin followed by autologous stem cell reconstitution did not appear to improve outcome and the investigators did not recommend this strategy for the treatment of osteosarcoma.

Laboratory studies using cell lines and xenografts suggested that bisphosphonates had activity against osteosarcoma.[43] A single-institution clinical trial demonstrated that pamidronate could safely be administered along with multiagent chemotherapy to patients with newly diagnosed osteosarcoma.[43] The French pediatric and adult sarcoma cooperative groups performed a prospective trial for the treatment of osteosarcoma.[44] All patients received multiagent chemotherapy, and patients were randomly assigned to receive or not to receive zoledronate. The addition of zoledronate did not improve EFS.