Future Directions in the Treatment of Osteosarcoma

Cells. 2021 Jan 15;10(1):172. doi: 10.3390/cells10010172.

Abstract

Osteosarcoma is the most common primary bone sarcoma and is often diagnosed in the 2nd-3rd decades of life. Response to the aggressive and highly toxic neoadjuvant methotrexate-doxorubicin-cisplatin (MAP) chemotherapy schedule is strongly predictive of outcome. Outcomes for patients with osteosarcoma have not significantly changed for over thirty years. There is a need for more effective treatment for patients with high risk features but also reduced treatment-related toxicity for all patients. Predictive biomarkers are needed to help inform clinicians to de-escalate or add therapy, including immune therapies, and to contribute to future clinical trial designs. Here, we review a variety of approaches to improve outcomes and quality of life for patients with osteosarcoma with a focus on incorporating toxicity reduction, immune therapy and molecular analysis to provide the most effective and least toxic osteosarcoma therapy.

Keywords: MAP; adolescent and young adult; chemotherapy; genomic heterogeneity; immunotherapy; osteosarcoma; patient outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / psychology
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Immunotherapy
  • Male
  • Medical Oncology / trends*
  • Methotrexate / administration & dosage
  • Neoadjuvant Therapy
  • Osteosarcoma / drug therapy*
  • Osteosarcoma / psychology
  • Precision Medicine
  • Prognosis
  • Quality of Life
  • Treatment Outcome

Substances

  • Doxorubicin
  • Cisplatin
  • Methotrexate