Interferon Shows No Benefit in EURAMOS-1 Trial

Published July 10, 2015
Journal of Clinical Oncology

Adding pegylated interferon to post-surgery maintenance therapy for people with osteosarcoma showed no clear benefit beyond existing standard chemotherapy, according to recent findings from the ongoing EURAMOS-1 clinical trial.

Rajaram Nagarajan, MD, MS, clinical director for Oncology, was among the leading co-authors on the paper, which reports results from one of multiple studies under way through a large-scale, international clinical trial group. Details were published in July 2015 in the Journal of Clinical Oncology.

The European and American Osteosarcoma Study Group (EURAMOS) was founded in 2001 to improve survival rates for the most common form of bone cancer affecting children. The group’s first study, EURAMOS-1, was launched in 2005.

Cincinnati Children’s is a member of the Children’s Oncology Group (COG), one of four major pediatric oncology groups involved in EURAMOS. Nagarajan helped develop the Quality of Life Study component of the trial. Analysis continues for those results.

With more than 2,200 patients registered from more than 300 medical centers, EURAMOS is the largest osteosarcoma study ever conducted. The study involved 716 patients.

The team found that 77 percent of patients receiving pegylated interferon alfa-2b (IFN-a-2b survived three years with no further cancer events, compared to 74 percent without adding interferon. The difference was not statistically significant.

“No change in practice is indicated by these data,” authors wrote.

Nagarajan says the study proves that a large, international collaboration can produce useful results, which builds a foundation for future clinical trials.

“Though these results were negative, it helped answer the question of whether interferon was beneficial,” he says. “Now, focus can be placed on other therapeutic modalities and drugs.”

Fig A: This graph shows minimal difference between overall survival rates for people with osteosarcoma when treated with MAP chemotherapy (methotrexate, doxorubin and cisplatin) versus receiving MAP plus interferon therapy.
Click image to view caption.

Citation

Bielack SS, Smeland S, Whelan JS, Marina N, Jovic G, Hook JM, Krailo MD, Gebhardt M, Papai Z, Meyer J, Nadel H, Randall RL, Deffenbaugh C, Nagarajan R, Brennan B, Letson GD, Teot LA, Goorin A, Baumhoer D, Kager L, Werner M, Lau CC, Sundby Hall K, Gelderblom H, Meyers P, Gorlick R, Windhager R, Helmke K, Eriksson M, Hoogerbrugge PM, Schomberg P, Tunn PU, Kuhne T, Jurgens H, van den Berg H, Bohling T, Picton S, Renard M, Reichardt P, Gerss J, Butterfass-Bahloul T, Morris C, Hogendoorn PC, Seddon B, Calaminus G, Michelagnoli M, Dhooge C, Sydes MR, Bernstein M, EUROMOS-1 investigators. Methotrexate, Doxorubicin, and Cisplatin (MAP) Plus Maintenance Pegylated Interferon Alfa-2b Versus MAP Alone in Patients With Resectable High-Grade Osteosarcoma and Good Histologic Response to Preoperative MAP: First Results of the EURAMOS-1 Good Response Randomized Controlled Trial. J Clin Oncol. 2015 Jul 10;33(20):2279-87.

A photo of Rajaram Nagarajan.

Rajaram Nagarajan, MD, MS