Stratifying Osteosarcoma: Minimizing and Maximizing Therapy

Abstract

Patients who are newly diagnosed with osteosarcoma face a daunting year of medical and surgical therapy, often filled with hospitalizations and changes in lifestyle. Fortunately, the majority of patients endure this struggle to become long-term survivors. However, follow-up studies of cancer survivors are revealing the sequelae of this curative therapy. Just as disturbingly, there remains a large subset of patients for whom conventional therapy is inadequate and who succumb to disease. In this review, we propose that therapeutic strategies for osteosarcoma patients must rely on stratification of patients into risk categories, in order to minimize therapy for some, while expanding treatment for others. We then focus on two molecular targets for the treatment of patients with high-risk osteosarcoma.

A novel synthetic derivative of the natural product berbamine inhibits cell viability and induces apoptosis of human osteosarcoma cells, associated with activation of JNK/AP-1 signaling

“…3 However, the prognosis of patients with metastasis or recurrence is still poor, with only 20% achieving a 5-y survival rate. 4 Metastatic cells have specific features that render them less sensitive to conventional chemotherapy (cisplatin, doxorubicin, and high-dose methotrexate), which targets the primary osteosarcoma tumors. 5,6 Therefore, it is critical to find new drugs for treatment of metastatic and recurrent osteosarcoma.…”

The Spectrum of Gnathic Osteosarcoma: Caveats for the Clinician and the Pathologist

“…However, there is a small group of early stage tumors that are cured by surgery alone. The majority of tumors though, presents in more advanced stages and require combination treatment [8]. Prognostic information can be attributed to some genetic and molecular aberrations, and to the proportion of tumor necrosis secondary to neo-adjuvant chemotherapy [9].…”

Molecular Reclassification in Pediatric Osteosarcomas at Surgical Resection is a Potential Helpful Prognostic Marker

“…Most of the studies, even in our Lab, were focusing on diagnostic samples to determine really early the chemoresistant osteosarcomas [5][6][7][8][13][14][15][16][17]. Nevertheless, this risk re-stratification is necessary to adapt the treatment but, for instance, was mostly based on clinical features [18][19][20][21]. The first explanation in the difficulty to find one or multiple biomarkers useful in osteosarcoma re-stratification and risk assessment is the complexity and the heterogeneity of this cancer [22,23].…”