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The largest osteosarcoma trial ever run, across four cooperative groups on two continents. Neither adding interferon for good responders nor adding ifosfamide and etoposide for poor responders improved outcomes, so three-drug MAP chemotherapy remained the standard and the field turned to new biology.
2,260 patients registered from 325 sites in 17 countries between 2005 and 2011. Poor responders (at least 10% viable tumour after MAP induction; 618 randomised) had identical event-free survival with MAPIE versus MAP (HR 0.98) and substantially more toxicity (Marina et al., Lancet Oncol 2016). Good responders (716 randomised) had no significant EFS gain from maintenance pegylated interferon alfa-2b, with 3-year EFS 76% overall and a large proportion never starting or stopping interferon early (Bielack et al., JCO 2015). EURAMOS-1 defined MAP (high-dose methotrexate, doxorubicin, cisplatin) as the international standard, showed that intensifying chemotherapy on the basis of histological response does not help, and demonstrated that four national groups could run one protocol. Its biobank underpins later genomic work on osteosarcoma.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
2,260 registered.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Event-free survival, poor responders (MAPIE vs MAP)primary | MAPIE | 310 | 154 events | 0.98 | - | link |
| MAP | 308 | 153 events | ||||
| 3-year event-free survival, good responders (all randomised) | MAP with or without interferon alfa-2b | 716 | 76% | - | - | link |
One cancer page and one trial page on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Shares SIOP Europe (European Society for Paediatric Oncology), Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Methotrexate, Children's Oncology Group (COG) and the tag paediatric.
Shares SIOP Europe (European Society for Paediatric Oncology), Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Rare and paediatric cancers without markets and the tag paediatric.
Shares Ifosfamide, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Children's Oncology Group (COG), Etoposide and the tag paediatric.
Shares Children's Oncology Group (COG), Doxorubicin, Cisplatin, Cytotoxic chemotherapy and the tag paediatric.
Shares Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Children's Oncology Group (COG), Etoposide, Doxorubicin and the tag paediatric.
Shares SIOP Europe (European Society for Paediatric Oncology), Ifosfamide, Children's Oncology Group (COG), Rare and paediatric cancers without markets and the tag paediatric.
Shares Rare and paediatric cancers without markets and the tag paediatric.
Shares SIOP Europe (European Society for Paediatric Oncology), Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Children's Oncology Group (COG), Rare and paediatric cancers without markets and the tag paediatric.