EURAMOS-1
The largest osteosarcoma trial ever run, across four cooperative groups on two continents. Neither adding interferon for good responders nor adding ifosfamide and etoposide for poor responders improved outcomes, so three-drug MAP chemotherapy remained the standard and the field turned to new biology.
Overview
2,260 patients registered from 325 sites in 17 countries between 2005 and 2011. Poor responders (at least 10% viable tumour after MAP induction; 618 randomised) had identical event-free survival with MAPIE versus MAP (HR 0.98) and substantially more toxicity (Marina et al., Lancet Oncol 2016). Good responders (716 randomised) had no significant EFS gain from maintenance pegylated interferon alfa-2b, with 3-year EFS 76% overall and a large proportion never starting or stopping interferon early (Bielack et al., JCO 2015). EURAMOS-1 defined MAP (high-dose methotrexate, doxorubicin, cisplatin) as the international standard, showed that intensifying chemotherapy on the basis of histological response does not help, and demonstrated that four national groups could run one protocol. Its biobank underpins later genomic work on osteosarcoma.
- The treated group had about 2 percent lower chance of the event at any given time (hazard ratio 0.98).
- The absolute difference, how many more people out of 100 were helped, is not reported here.
- 154 events 153 events
- 76 out of 100 people free of a major event at 3 years with MAP with or without interferon alfa-2b.
- There was no comparison group, so this number cannot tell you how much of the effect is due to the treatment.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Resectable high-grade osteosarcoma, age up to 40: MAP induction, then randomisation by histological response (good responders: MAP vs MAP + pegylated interferon alfa-2b; poor responders: MAP vs MAPIE with ifosfamide and etoposide). People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
2,260 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Event-free survival, poor responders (MAPIE vs MAP)primary | MAPIE | 310 | 154 events | 0.98 | — | link |
| MAP | 308 | 153 events | ||||
| 3-year event-free survival, good responders (all randomised) | MAP with or without interferon alfa-2b | 716 | 76% | — | — | link |
Pages like this
not linked directly; found by shared links- TrialInter-B-NHL Ritux 2010
Shares SIOP Europe – European Society for Paediatric Oncology, Etoposide, Methotrexate, Doxorubicin and the tags nci-coverage, paediatric.
- CancerChildhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours)
Shares Ifosfamide, SIOP Europe – European Society for Paediatric Oncology, Doxorubicin, Children's Oncology Group (COG) and the tags nci-coverage, paediatric.
- CancerGerm cell tumours of childhood and adolescence (extracranial and CNS)
Shares Ifosfamide, SIOP Europe – European Society for Paediatric Oncology, Etoposide, Cisplatin and the tags nci-coverage, paediatric.
- CancerNUT carcinoma (midline carcinoma with NUTM1 rearrangement)
Shares Ifosfamide, Etoposide, Cisplatin, Rare and paediatric cancers without markets and the tags nci-coverage, paediatric.
- CancerAtypical teratoid/rhabdoid tumour (ATRT)
Shares SIOP Europe – European Society for Paediatric Oncology, Methotrexate, Cisplatin, Children's Oncology Group (COG) and the tags nci-coverage, paediatric.
- InstitutionACCELERATE
Shares SIOP Europe – European Society for Paediatric Oncology, Rare and paediatric cancers without markets and the tags nci-coverage, paediatric.
- TrialCOG AREN0533
Shares Etoposide, Doxorubicin, Children's Oncology Group (COG) and the tags nci-coverage, paediatric.
- InstitutionInnovative Therapies for Children with Cancer (ITCC)
Shares SIOP Europe – European Society for Paediatric Oncology, Rare and paediatric cancers without markets and the tags nci-coverage, paediatric.