doxorubicin + cisplatin + ifosfamide-Italian Sarcoma Group-high-grade bone sarcoma

Doxorubicin + cisplatin + ifosfamide (with or without methotrexate) is an intensive combination chemotherapy regimen developed by the Italian Sarcoma Group (ISG) in collaboration with the Cooperative Osteosarcoma Study Group (COSS) and the Scandinavian Sarcoma Group (SSG). This protocol was specifically designed for the treatment of high-grade bone sarcomas in patients aged 41 to 65 years, a population historically excluded from pediatric-based osteosarcoma trials. Evaluated in the prospective EURO-B.O.S.S. (EUROpean Bone Over 40 Sarcoma Study) trial, the regimen utilizes the cytotoxic properties of three small molecule agents: doxorubicin (DNA intercalation and topoisomerase II inhibition), cisplatin (DNA cross-linking), and ifosfamide (DNA alkylation). In cases of poor histologic response to induction therapy, methotrexate is added postoperatively to enhance anti-tumor efficacy. This regimen represents the first international effort to standardize intensive chemotherapy for older patients with rare primary malignant bone tumors, including high-grade osteosarcoma, undifferentiated pleomorphic sarcoma, and dedifferentiated chondrosarcoma.

Other names

EURO-B.O.S.S. regimenISG-EUROBOSS protocoldoxorubicin + cisplatin + ifosfamide + methotrexate