Chemotherapy for Osteosarcoma

Chemotherapy drugs are used to kill cancer cells. These drugs destroy cancer that is still left after surgery, slow the tumor's growth, or reduce symptoms. Most cases of osteosarcoma are treated with chemotherapy before surgery to shrink the tumor (neoadjuvant therapy) and after surgery (adjuvant therapy) to kill any cancer cells left in the body. The chemotherapy drugs used for osteosarcoma are usually injected into a vein, although they are sometimes taken by mouth or injected under the skin to limit their side effects.

• Adriamycin^® (doxorubicin) - Doxorubicin hydrochloride belongs to the group of chemotherapy drugs known as anthracycline antibiotics. Doxorubicin stops the growth of cancer cells, causing them to die. This drug is given by a shot in a vein over about 15 minutes. The dose and how often you get the medicine depend on your size, your blood counts, how well your liver works, and the type of cancer you have.
• Blenoxane^® (bleomycin) - Bleomycin belongs to the group of chemotherapy drugs known as antibiotics. Bleomycin interferes with cell division, which destroys the cells. Bleomycin is given by a shot into a vein, either over 10 minutes or as a continuous infusion for 24 hours, or as a shot into the muscle or under the skin. The dose is based on your size.
• Cytoxan^® or Neosar^® (cyclophosphamide) - Cyclophosphamide belongs to a group of chemotherapy drugs known as alkylating agents. It stops the growth of cancer cells, causing them to die. This drug can be given by mouth as a pill or liquid, or by a shot into a vein. The dose depends upon your size, your blood counts, and your type of cancer.
• Ifex^® (ifosfamide) - Ifosfamide belongs to a group of chemotherapy drugs known as alkylating agents. Ifosfamide stops cancer cells from growing, which kills them. Ifosfamide is given as an injection in a vein over 1 to 24 hours for a few days. The dose depends on your size, how well your kidneys are working, your blood counts, and the type of cancer being treated.
• Paraplatin^® (carboplatin) - Carboplatin is a platinum chemotherapy drug that belongs to a group of drugs known as alkylating agents. It stops cancer cells from growing, which kills them. Carboplatin is given as an injection in the vein over 15 to 60 minutes. The dose depends upon your size but may be lowered or not given if your blood counts are low.
• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.
• Rheumatrex^® or Trexall™ (methotrexate) - Methotrexate belongs to a group of chemotherapy drugs known as antimetabolites. It prevents cells from making DNA and RNA, which stops the growth of cancer cells. Methotrexate is given as a pill by mouth, an injection in a vein for up to 20 minutes, or an injection into a muscle. The dose depends on your size, your blood counts, the type of cancer you have, and how well your kidneys work.
• VePesid^® or Etopophos^® (etoposide) - Etoposide belongs to the class of chemotherapy drugs known as plant alkaloids. It stops cells from dividing, which kills them. Etoposide can be given by an injection in a vein over 30 to 60 minutes, or at higher doses over 1 to 4 hours. Etoposide can also be given by mouth as a capsule. The dose depends on your size, your blood counts, and the type of cancer being treated.
      

Usually, several chemotherapy drugs are given at the same time. The most common combinations are:

• Doxorubicin and cisplatin
  
• Dactinomycin, bleomycin, and cyclophosphamide
  
• Ifosfamide and etoposide

This content has been reviewed and approved by Myo Thant, MD.