Research on osteosarcoma is now being done at many medical centers, university hospitals, and other institutions across the world.
Understanding osteosarcoma
Researchers are making progress in learning about the causes of osteosarcoma. It is hoped that more information about the DNA changes that cause this cancer will eventually result in the development of specific treatments to correct these changes. Tests of gene changes called gene expression profiling may help predict the behavior of each tumor, such as how they respond to certain types of chemotherapy. These are still being tested in clinical trials.
Treatment
Great advances have been made in treating osteosarcoma in the past few decades. There are many clinical trials focusing on treating osteosarcoma using a variety of strategies.
Surgery
Doctors now have a much better understanding of the typical growth and spread of osteosarcomas than they did in the past. This, along with newer imaging tests that better define the extent of tumors, lets them plan surgeries that remove the cancer while sparing as much normal tissue as possible.
Some newer types of internal prostheses (man-made devices used to replace pieces of bone) can now be expanded without the need for more surgery. This is especially important for children, who in the past often needed several operations to replace the prosthesis with a larger one as they grew.
Chemotherapy
Clinical trials are being done to determine the best combinations of chemotherapy drugs, as well as the best time to give them. Newer chemotherapy drugs are being studied as well.
The lungs are the most common place for osteosarcoma to spread. Inhaled forms of some chemotherapy drugs (such as cisplatin) are being studied for patients whose cancer has spread to their lungs. Early results have been promising.
Other new forms of treatment
Chemotherapy drugs are often effective against osteosarcoma, but in some cases they don't work or the cancer becomes resistant to them over time. Researchers are studying newer types of drugs that attack osteosarcoma cells in different ways
Clinical trials are looking into ways to help the patient's immune system recognize and attack the osteosarcoma cells. An experimental immune-modulating drug called muramyl tripeptide (also known as MTP or mifamurtide) has been shown to help some patients when added to chemotherapy.
Doctors are also studying new medicines that target specific molecules on the cancer cells. These are known as targeted therapies. Some of these are man-made versions of immune system proteins, known as monoclonal antibodies. These antibodies attach to certain proteins on the cancer cell and help to stop the growth or kill the cancer cells. Examples now being studied include antibodies against the insulin-like growth factor receptor 1 (IGF-1R), a protein that may help cancer cells grow.
Other drugs that target bone cells called osteoclasts may also be useful against osteosarcoma. Bisphosphonates are a group of drugs that are already used to treat osteoporosis (bone thinning) and certain cancers that have spread to the bone. Some of these drugs, such as pamidronate and zoledronic acid, are now being studied for use in patients with osteosarcoma as well. Another drug that affects bones, known as saracatinib (AZD0530), is also under study.
Other new drugs being studied for use against osteosarcoma include:
- Drugs that affect a tumor's ability to make new blood vessels, such as bevacizumab (Avastin), cediranib, and sorafenib (Nexavar).
- Drugs that target the mTOR protein, such as temsirolimus (Torisel) and everolimus (Afinitor).
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