Liposomal muramyl tripeptide phosphatidyl ethanolamine: a safe and effective agent against osteosarcoma pulmonary metastases

摘要

Osteosarcoma is the most common form of primary malignant bone tumor. The use ofnchemotherapy drugs with many side effects, including high-dose methotrexate, doxorubicin,ncisplatin and ifosfamide, has greatly improved osteosarcoma survival compared with surgerynalone. However, for 20 years, overall survival remained at a plateau of 60–70% innnonmetastatic disease and 20–30% in metastatic osteosarcoma owing to lung metastases.nLiposomal muramyl tripeptide phosphatidyl ethanolamine (L-MTP-PE) is a new agent thatnimproves overall osteosarcoma survival (chemotherapy without L-MTP-PE 70% versus withnL-MTP-PE 78%; p = 0.03). L-MTP-PE offers additional benefit for osteosarcoma treatment inncombination with chemotherapy, particularly ifosfamide-containing regimens. Clinicalnexperience indicates that side effects such as fever are temporary and controlled or preventednwith ibuprofen and/or acetoaminophen premedication; severe side effects are rare. Althoughnsurgery will remain the main approach for osteosarcoma treatment of lung metastases,nL-MTP-PE combined with other modalities, including chemotherapy, appears to be of benefitnin these patients as well.