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.

Chemotherapy

Some clinical trials are looking into ways to combine surgery, radiation therapy, and chemotherapy (chemo). Some are testing new chemo drugs.

Targeted therapy

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, LBH589, is being studied in combination with imatanib to treat chordoma.

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^®) and vismodegib (GDC-0449) in chondrosarcoma.

Denosumab is a drug designed to treat osteoporosis and cancer that has spread to bone. One small study showed that it may be very effective in treating giant cell tumors of bone that have spread or cannot be removed with surgery. A larger study of this is going on now.

Radiation

Some studies are looking at the best ways to give radiation to treat bone cancers. For example, studies are comparing proton beam radiation with carbon ion radiation in treating chordomas and chondrosarcomas of the skull base.

Genetics

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. Hopefully more information about the DNA changes that cause bone cancers will eventually lead to treatments aimed at these gene defects.