title: [Treatment of metastatic osteosarcoma with verapamil, cyclosporine and chemotherapy. A case report].
abstract: Studies on the use of revertants to overcome MDR have aroused a great interest even if they failed to prove their actual usefulness. A case of 10 years and 6 months old boy is described. He suffered from osteoblastic osteosarcoma and underwent chemotherapy following CNR-NEO3 protocol, wide surgical resection and postoperative chemotherapy. Nineteen months after diagnosis he underwent the removal of a little subpleural nodule in the right lung. Forty-five days later, in the same site, a large local metastasis was observed together with many others secondaries localizations spred in both lungs. Because of the rapid evolution they were considered not suitable for surgical treatment. A cyclosporine and verapamil treatment in association with adryamicin and etoposide was begun with the aim overcoming multidrug resistance. Five treatments were provided. ECG monitoring during verapamil infusion did not show any trouble; mielotoxicity was mild, with no need of transfusions. A lung CT scan at the end of the therapy demonstrated an important decrease of the subpleural metastasis and the vanishing of lung nodules. Another surgical intervention was provided together with 2 postoperative chemotherapy treatments. Twenty-six months later no sign of the disease was observed. Association of verapamil and cyclosporine with chemotherapy allowed to get a good clinical response with a very low toxicity, in a critical situation in which chemotherapy alone did not seem to offer any real possibility.
authors.affiliation: Istituto di Discipline Pediatriche, Università degli Studi, Torino.
authors.forename: A
authors.initials: A
authors.lastname: Brach Del Prever
authors.forename: F M
authors.initials: FM
authors.lastname: Massara
authors.forename: L
authors.initials: L
authors.lastname: Besenzon
authors.forename: M
authors.initials: M
authors.lastname: Bianchi
authors.forename: P
authors.initials: P
authors.lastname: Picci
authors.forename: A
authors.initials: A
authors.lastname: Briccoli
authors.forename: R
authors.initials: R
authors.lastname: Miniero
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use*; D005269:Femur / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000188:drug therapy* / Q000556:secondary* / Q000628:therapy; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D016572:Cyclosporine; D014700:Verapamil
vernacular_title: Trattamento dell'osteosarcoma metastatico con verapamile, ciclosporina e chemioterapia. Descrizione di un caso clinico.