title: May P-glycoprotein status be used to stratify high-grade osteosarcoma patients? Results from the Italian/Scandinavian Sarcoma Group 1 treatment protocol.
abstract: The aim was to evaluate the clinical impact of P-glycoprotein in primary non-metastatic high-grade osteosarcoma patients, treated with neoadjuvant chemotherapy protocols. P-glycoprotein was assessed by immunohistochemistry on paraffin-embedded tissue samples collected at time of diagnosis from 94 osteosarcoma patients, treated with the Italian Sarcoma Group/Scandinavian Sarcoma Group 1 (ISG/SSG 1) protocol. P-glycoprotein-positivity at diagnosis was found in 53/94 ISG/SSG 1 cases (56%) and emerged as the single factor significantly associated with an unfavourable outcome from survival and multivariate analyses. A comparative analysis of the subgroup of 94 patients considered for P-glycoprotein evaluation and the whole series of ISG/SSG 1 patients showed that this marker retained its prognostic value also in the latter group. In osteosarcoma patients treated with doxorubicin-based chemotherapy protocols, P-glycoprotein overexpression at diagnosis is an important adverse prognostic factor for outcome. P-glycoprotein evaluation can therefore constitute the basis for stratifying, at diagnosis, osteosarcoma patients for whom alternative treatments may be considered.
authors.affiliation: Laboratorio di Ricerca Oncologica, Istituti Ortopedici Rizzoli, 40136 Bologna, Italy. massimo.serra@ior.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Serra
authors.forename: Michela
authors.initials: M
authors.lastname: Pasello
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Manara
authors.forename: Katia
authors.initials: K
authors.lastname: Scotlandi
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Franco
authors.initials: F
authors.lastname: Bertoni
authors.forename: Mario
authors.initials: M
authors.lastname: Mercuri
authors.forename: Thor Andreas
authors.initials: TA
authors.lastname: Alvegard
authors.forename: Piero
authors.initials: P
authors.lastname: Picci
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bacci
authors.forename: Sigbjørn
authors.initials: S
authors.lastname: Smeland
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000096:biosynthesis*; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002648:Child; D004317:Doxorubicin / Q000008:administration & dosage; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D004317:Doxorubicin