Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma

Cancer, 08/03/2009

Chou AJ et al. - In a study to examine the addition of liposomal muramyl tripeptide phosphatidylethanolamine (MTP-PE) to chemotherapy for pts with metastatic osteosarcoma (OS), it was found that when the metastatic cohort was considered in isolation, addition of liposomal MTP-PE to chemotherapy did not achieve a statistically significant improvement in outcome. But the pattern of outcome is similar to the pattern in nonmetastatic pts.


  • Intergroup-0133 was a prospective randomized phase 3 trial for the treatment of newly diagnosed pts with OS.
  • 3-drug chemotherapy with cisplatin, doxorubicin, and high-dose methotrexate (Regimen A) was compared with the same 3 drugs with the addition of ifosfamide (Regimen B).
  • Addition of liposomal MTP-PE to chemotherapy was evaluated.


  • 5-yr event-free survival (EFS) for pts who received liposomal MTP-PE (n=46) was 42% vs 26% for those who did not (n=45).
  • 5-yr overall survival for pts who received MTP-PE vs no MTP-PE was 53% and 40%, respectively.
  • The comparison of Regimen A with Regimen B did not suggest a difference for EFS (35% vs 34%, respectively) or overall survival (52% vs 43%, respectively).

Print Article Summary Cat 2 CME Report