Presented at the American Society of Clinical Oncology Annual Meeting, June 1–5, 2007.
Transfer of complex frontline anticancer therapy to a developing country: The St. Jude osteosarcoma experience in Chile†
Article first published online: 17 DEC 2007
Copyright © 2007 Wiley-Liss, Inc.
Pediatric Blood & Cancer
Volume 50, Issue 6, pages 1143–1146, June 2008
How to Cite
Rivera, G. K., Quintana, J., Villarroel, M., Santana, V. M., Rodriguez-Galindo, C., Neel, M. D., Velez, G., Ribeiro, R. C. and Daw, N. C. (2008), Transfer of complex frontline anticancer therapy to a developing country: The St. Jude osteosarcoma experience in Chile. Pediatr. Blood Cancer, 50: 1143–1146. doi: 10.1002/pbc.21444
- Issue published online: 1 APR 2008
- Article first published online: 17 DEC 2007
- Manuscript Accepted: 16 OCT 2007
- Manuscript Received: 9 JUL 2007
- USPHS awards. Grant Number: CA 23099
- Cancer Center Support Grant. Grant Number: CA 21765
- American Lebanese Syrian Associated Charities
- collaborative clinical research trial;
- pediatric oncology;
A frontline protocol for newly diagnosed osteosarcoma was conducted simultaneously at St. Jude Children's Research Hospital (sponsor) and Calvo Mackenna Hospital (CMH, partner), a public pediatric hospital and national center for the treatment of bone tumors in Santiago, Chile.
Of 72 eligible patients, 22 (31%) were enrolled and managed in Santiago, without travel to Memphis. Pathology specimens and imaging material were centrally reviewed at St. Jude. Patients received 12 intensive courses of systemic chemotherapy with hematopoietic growth factor support over 35 weeks, and amputation or limb-salvage surgery as indicated for local control. The sponsor assisted the partner site to establish a clinical research infrastructure and obtain hematopoietic growth factor. Communication among medical and nursing teams was maintained throughout the study. Patient-care and protocol issues were discussed frequently between the two centers via scheduled videoconferences and electronic communications. Auditors monitored appropriate study conduct at the international site.
No major discrepancies were identified in histologic findings, staging, or imaging studies. Preliminary results demonstrated similar outcome and treatment tolerance; the 2-year event-free survival estimate was 78.5% (95% CI, 51–100%) for patients treated at CMH (median follow-up, 1.6 years) and 74.3% (95% CI, 62–87%) for patients treated at St. Jude (median follow-up, 4 years). Overall per-patient costs were significantly lower in Chile.
Through a twinning mechanism, it is feasible to simultaneously conduct complex front-line osteosarcoma clinical trials at two institutions in countries with different levels of resources. Pediatr Blood Cancer 2008;50:1143–1146. © 2007 Wiley-Liss, Inc.