Current and future therapeutic approaches for osteosarcoma

Abstract

Current treatment of osteosarcoma includes surgical resection of all gross disease in conjunction with systemic chemotherapy to control micro-metastatic disease. This yields a 5-year event free survival (EFS) of approximately 70% for patients with localized osteosarcoma while patients with metastatic or recurrent disease fare poorly with overall survival rates of less than 20%. Areas covered: This review outlines the current and future approach towards the treatment of osteosarcoma. A literature search was performed utilizing PubMed. Several recent clinical trials are reviewed in detail, as is innovative research evaluating novel agents and surgical techniques which hold promise. Expert commentary: The outcome for patients with osteosarcoma has not changed in several decades. This plateau in survival rates highlights the need for a novel approach towards research. There remains a great deal of interest in utilizing the very high risk population of recurrent osteosarcoma patients to rapidly and sequentially evaluate novel agents to determine if any of these agents hold promise. Several phase II studies are ongoing or in development that offer hope based on intriguing preclinical data. Furthermore, initiatives in obtaining specimens to further explore the genetic and immunological profile behind osteosarcoma will be essential towards identifying novel pathways and targets to exploit.

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“…Since plants are often exposed to extreme environmental conditions, they have evolved to produce different types of secondary metabolites. These metabolites have been shown to be beneficial in the treatment of human diseases [13]. Evodiamine is an important plant-derived alkaloid that has been reported to inhibit the growth of cancer cells [14,15].…”

Long Noncoding RNA FER1L4 Suppresses Tumorigenesis by Regulating the Expression of PTEN Targeting miR-18a-5p in Osteosarcoma

“…The development and progression of OS occurs through a series of sequential and complex steps that involves the aberrant expression of several genes [23,24]. Some LncRNAs are proven to play crucial roles in the initiation and development of OS, as oncogenes or tumor suppressors [9,10].…”

Factors influencing survival after recurrence in osteosarcoma: A report from the Children's Oncology Group

“…10 The Children’s Oncology Group (COG) has initiated a series of phase II clinical trials aimed at identifying novel agents that have activity against osteosarcoma. 11 However, the design of these studies is limited by the historical data for survival of relapsed patients treated on prior clinical trials.…”