Cancers & treatments·Regimen libraryCurative

MAP (methotrexate, doxorubicin, cisplatin)

Checked 2026-09-09

Resectable high-grade osteosarcoma, patients under 40: 10 weeks before surgery, then postoperative cycles to about 29 weeks

One cycle

every 35 days × 2 · about 10 weeks in total

35-day cycle × 2 preoperative blocks; postoperative blocks to complete 12 methotrexate doses (about 10 weeks)Intravenous Continuous infusion

Components

Drug	Dose	Route	Days
Cisplatin Cytotoxic chemotherapy (platinum)	120 mg/m²	IV	D1
Doxorubicin Cytotoxic chemotherapy (anthracycline)	37.5 mg/m² per day	IV	D1, 2
High-dose methotrexate Antifolate (DHFR inhibitor)	12 g/m² (maximum 20 g) with leucovorin rescue	IV	D22, 29 (4 h infusion)

Cycles

2 preoperative blocks; postoperative blocks to complete 12 methotrexate doses

35-day cycle

Emetogenicity

High (>90%)

G-CSF

Consider (10-20% FN risk)

Notes

Methotrexate levels at 24, 48 and 72 hours with leucovorin until below 0.1 µmol/L; hydrate and alkalinise urine.
Cumulative doxorubicin 450 mg/m²: dexrazoxane is used in some protocols.

Used in

Osteosarcoma

Products

CisplatinDoxorubicinMethotrexate

Source

EURAMOS-1, Lancet Oncology 2016

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

All regimens Temozolomide chemoradiation then adjuvant temozolomide (Stupp) →