Pirarubicin ( THP ) is a newer generation anthracycline anticancer drug with antineoplastic efficacy against numerous tumors.
Few studies have reported its application and efficiency in anti-osteosarcoma chemotherapeutic strategies.

Ninety-six non-metastatic extremity osteosarcoma patients treated with Pirarubicin or Doxorubicin ( DOX ) in combination with high-dose Methotrexate ( HDMTX ), Cisplatin ( DDP ) and Ifosfamide ( IFO ) within the past 9 years at Sixth People's Hospital ( Shanghai, China ) were evaluated retrospectively to compare efficacy and side effects.

Among the patients, 55.2% were male, 36.5% were less than or equal to 14 years old and 59.4% presented with a large tumor ( greater than or equal to 1/3 of bone ) to the Department of Oncology.

The 5-year disease-free survival ( DFS ) rate of the patients treated with the Pirarubicin-based chemotherapeutic regimen was 70.2%, significantly higher than that of the Doxorubicin-based regimen-treated group ( 53.1% ).

The Pirarubicin-based chemotherapeutic regimen decreased the lung metastatic rate significantly compared with the Doxorubicin-based regimen ( 19.1% vs. 36.7%, P=0.045 ), as well as the relapse rate ( 31.9% vs. 49.0%, P=0.067 ).

Both regimens were generally well tolerated. However, while the Pirarubicin-based chemotherapeutic regimen did not alter toxicity in the hematologic system, liver or kidneys compared with the Doxorubicin-based regimen, it showed lower rates of alopecia ( 63.8% vs. 85.7%, P=0.012 ), nausea and vomiting ( 51.1% vs. 79.6%, P=0.003 ), and mucositis ( 48.9% vs. 75.6%, P=0.003 ).

Pirarubicin also resulted in lower cardiac toxicity.

The data have demonstrated that the Pirarubicin-based regimen is better than the Doxorubicin-based regimen in terms of the 5-year disease-free survival rate, pulmonary metastasis rate, relapse rate and side effects. ( Xagena )

Zheng S et al, Am J Cancer Res 2014;5:411-422

XagenaMedicine2014