MAP (methotrexate, doxorubicin, cisplatin)
Checked 2026-09-09
Resectable high-grade osteosarcoma, patients under 40: 10 weeks before surgery, then postoperative cycles to about 29 weeks
One cycle
every 35 days × 2 · about 10 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Cisplatin Cytotoxic chemotherapy (platinum) | 120 mg/m² | IV | D1 | |
Doxorubicin Cytotoxic chemotherapy (anthracycline) | 37.5 mg/m² per day | IV | D1, 2 | |
High-dose methotrexate Antifolate (DHFR inhibitor) | 12 g/m² (maximum 20 g) with leucovorin rescue | IV | D22, 29 (4 h infusion) |
Cycles
2 preoperative blocks; postoperative blocks to complete 12 methotrexate doses
35-day cycle
Emetogenicity
High (>90%)
G-CSF
Consider (10-20% FN risk)
Notes
- Methotrexate levels at 24, 48 and 72 hours with leucovorin until below 0.1 µmol/L; hydrate and alkalinise urine.
- Cumulative doxorubicin 450 mg/m²: dexrazoxane is used in some protocols.
Used in
Products
Source
EURAMOS-1, Lancet Oncology 2016
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.