What’s new in bone cancer research and treatment?
Research on bone cancer is now being done at many medical centers, university hospitals, and other institutions across the nation. There are several ongoing clinical trials focusing on bone cancer.
Some clinical trials are looking into ways to combine surgery, radiation therapy, and chemotherapy (chemo), and drugs known as targeted therapy. One study found that the combination of the chemo drug cyclophosphamide (Cytoxan) and the targeted drug sirolimus can help stop chondrosarcomas from growing for a time.
Some are testing new chemo drugs.
Targeted therapy drugs work differently from standard chemo. These drugs target certain genes and proteins in cancer cells.
One example of targeted therapy is the drug imatinib (Gleevec), which targets certain proteins made by the cancer cells in chordomas. Adding another drug to imatinib, such as the targeted therapy drug sirolimus (Rapamune®) or the chemo drug cisplatin helps stop the growth of chordomas when imatinib stops working. Another drug, panobinostat, is being studied in combination with imatanib to treat chordoma.
Lapatinib (Tykerb®) is another targeted drug that may be useful in treating chordoma. In one study of patients with tumors that had too many copies of the EGFR gene and/or too much EGFR protein, it helped shrink tumors and stop them from growing for a time.
Some chordomas show strong expression of parts of an insulin-like growth factor pathway. This has led to studying antibodies against the insulin-like growth factor receptor 1 (IGF-1R) in chordoma patients.
Studies of other targeted drugs are going on right now, such as nilotinib (Tasigna) and dasatinib (Sprycel) in chordoma, and pazopanib (Votrient®), everolimus (Afinitor®), and vismodegib (GDC-0449) in chondrosarcoma.
The most common type of radiation used to treat cancer uses beams of x-rays. Proton beam radiation uses particles made up of protons (protons are small positively charged particles that are part of atoms). Another much less common form of particle radiation that can be used to treat chordomas and chondrosarcomas is carbon ion radiation. This can be helpful in treating tumors of the skull base, but is only available in a few centers worldwide.
In addition to clinical trials, researchers are making progress in learning about the causes of bone tumors. For example, changes to a certain part of chromosome 6 have been found in chordomas. Changes the COL2A1 gene, which codes for a major form of collagen found in cartilage, have been found in many chondrosarcomas. Hopefully more information about the DNA changes that cause bone cancers will eventually lead to treatments aimed at these gene defects.
Last Medical Review: 03/21/2014
Last Revised: 02/25/2015