Future Directions in the Treatment of Osteosarcoma

• Published in: Cells (Basel, Switzerland) Vol. 10; no. 1; p. 172
• Main Authors: Smrke, Alannah, Anderson, Peter M, Gulia, Ashish, Gennatas, Spyridon, Huang, Paul H, Jones, Robin L
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.01.2021; MDPI
• Subjects: adolescent and young adult; Animals; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone cancer; Bone Neoplasms - drug therapy; Bone Neoplasms - psychology; Bone tumors; Bones; Breast cancer; Caregivers; Cell adhesion & migration; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin; Cisplatin - administration & dosage; Doxorubicin; Doxorubicin - administration & dosage; Female; genomic heterogeneity; Humans; Immunotherapy; Male; Medical Oncology - trends; Medical prognosis; Metastasis; Methotrexate; Methotrexate - administration & dosage; Mucositis; Neoadjuvant Therapy; Osteosarcoma; Osteosarcoma - drug therapy; Osteosarcoma - psychology; Patients; Pediatrics; Precision Medicine; Prognosis; Quality of Life; Review; Sarcoma; Surgery; Surveillance; Toxicity; Treatment Outcome; genomic heterogeneity; adolescent and young adult; immunotherapy; patient outcomes; MAP; chemotherapy; osteosarcoma
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells10010172

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.