Muramyl Tripeptide Plus Chemotherapy Reduces Metastasis in Non-Metastatic Osteosarcoma: A Single-Center Experience
| Autor: | Nurdan Tacyildiz, Omer Kartal, H Mine Çakmak, Emel Ünal, Kenan Köse, Gulsah Tanyildiz, Handan Dincaslan |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Surgical margin Adolescent retrospective study medicine.medical_treatment Metastasis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Recurrence Internal medicine Antineoplastic Combined Chemotherapy Protocols mifamurtide medicine metastasis Humans Neoplasm Metastasis Child Survival rate Osteosarcoma Chemotherapy treatment business.industry Phosphatidylethanolamines Osteonecrosis General Medicine medicine.disease Chemotherapy regimen 030104 developmental biology chemistry 030220 oncology & carcinogenesis Chills medicine.symptom business Acetylmuramyl-Alanyl-Isoglutamine Research Article Mifamurtide |
| Zdroj: | Asian Pacific Journal of Cancer Prevention : APJCP |
| ISSN: | 2476-762X |
| DOI: | 10.31557/apjcp.2020.21.3.715 |
| Popis: | Background The immunomodulator mifamurtide plus a chemotherapy regimen has been shown to significantly improve the outcome in non-metastatic osteosarcoma patients. We report the results of the addition of mifamurtide to chemotherapy in newly diagnosed patients with osteosarcoma. Methods A total of 36 children with osteosarcoma without detectable metastasis were treated between November 2010 and April 2018 at the Ankara University Department of Pediatric Oncology. Mifamurtide was added to the chemotherapy regimen in 17 patients while the remaining 19 did not receive mifamurtide. The probabilities of metastasis and overall survival were compared between the groups. Results The 43-month survival rate was 87.5% and 89.9% in the patients who received and did not receive mifamurtide, respectively (p=0.65). Common side effects of mifamurtide were chills and fever. The addition of mifamurtide in the high-risk group with ≤95% necrosis tended to decrease the probability of distant metastasis (36.4% vs. 58.3%) (p=0.39). The time to metastasis in the group with positive surgical margins (4 months in one patient in the non-mifamurtide group, 7 and 20 months in the mifamurtide group) was also longer in the mifamurtide group. During the 43-month follow up period, median time to metastasis was longer in the mifamurtide group (20 vs. 5 months). In addition, mifamurtide plus chemotherapy decreased the risk of metastasis in the cases with primary site relapse. Conclusions The addition of mifamurtide to chemotherapy might improve event-free survival by decreasing the probability of distant metastasis in bad histologic responders, and also by increasing the time to distant metastasis in the surgical margin positive group. Additional clinical studies are necessary to determine the long-term effects of mifamurtide on metastatic disease. . |
| Databáze: | OpenAIRE |
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