Systemic Anti-Cancer Therapy Regimen Library
SAR Osteosarcoma - MAP [metHOTREXATe, DOXOrubicin and cISplatin]
Treatment Overview
This regimen consists of two parts:
- MAP [metHOTEXATe, DOXOrubicin and cISplatin] for 4 cycles, usually administered as 2 Neoadjuvant cycles then surgery followed by 2 Adjuvant cycles. Consult protocol for details.
- MA [metHOTREXATe and DOXOrubicin] for 2 cycles.
In patients older than 40 years, consider using cISplatin and DOXOrubicin without high dose metHOTREXATe.
For 4 cycles, usually administered as 2 Neoadjuvant cycles then surgery followed by 2 Adjuvant cycles. Consult protocol for details.
For 2 cycles.
Supportive Care Factors
| Factor | Value |
|---|---|
| Emetogenicity: | Variable |
| Folinic acid rescue for high dose methotrexate: | Mandatory |
| Growth factor support: | Recommended for primary prophylaxis |
| Hydration: | Routine hydration recommended |
References
Childrens Oncology Group Euramos-1 A randomized trial of the European and American Osteosarcoma Study Group to optimize treatment strategies for resectable osteosarcoma based on histological response to pre-operative chemotherapyversion 3.0 21 July 2011 https://ascopubs.org/doi/suppl/10.1200/jco.2014.60.0734/suppl_file/Protocol_JCO.2014.60.0734.pdf
Castells, M.C., Matulonis, U.A., and Horton, TM. Infusion reactions to systemic chemotherapy. Savarese DMF and Feldweg AM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com/contents/infusion-reactions-to-systemic-chemotherapy (Accessed 26 March 2021).
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.