4.6 Review

Future Directions in the Treatment of Osteosarcoma

Journal

CELLS
Volume 10, Issue 1, Pages -

Publisher

MDPI
DOI: 10.3390/cells10010172

Keywords

osteosarcoma; chemotherapy; MAP; immunotherapy; genomic heterogeneity; adolescent and young adult; patient outcomes

Categories

Funding

  1. Royal Marsden/Institute of Cancer Research National Institute for Health Research Biomedical Research Centre - National Institute for Health Research

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Osteosarcoma, the most common primary bone sarcoma, is often diagnosed in the 2nd-3rd decades of life with outcomes not significantly changed for over thirty years. Response to neoadjuvant MAP chemotherapy is predictive of treatment outcome. Effective treatment with reduced toxicity is needed for high-risk patients, along with predictive biomarkers to guide therapy decisions.
Osteosarcoma is the most common primary bone sarcoma and is often diagnosed in the 2nd-3rd decades of life. Response to the aggressive and highly toxic neoadjuvant methotrexate-doxorubicin-cisplatin (MAP) chemotherapy schedule is strongly predictive of outcome. Outcomes for patients with osteosarcoma have not significantly changed for over thirty years. There is a need for more effective treatment for patients with high risk features but also reduced treatment-related toxicity for all patients. Predictive biomarkers are needed to help inform clinicians to de-escalate or add therapy, including immune therapies, and to contribute to future clinical trial designs. Here, we review a variety of approaches to improve outcomes and quality of life for patients with osteosarcoma with a focus on incorporating toxicity reduction, immune therapy and molecular analysis to provide the most effective and least toxic osteosarcoma therapy.

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