This article offers an introduction to osteosarcomas. Additionally, at the end, information is provided on osteosarcoma clinical trials open in Spain.
In this article you will learn about:
What Is Osteosarcoma?
Osteosarcoma is the most common type of cancer that originates in the bones [1].
It occurs when bone cells start to grow uncontrollably and may spread to other parts of the body.
Although it usually originates in the bones around the knee or in the upper arm bone, it can also appear in other bones.
This type of cancer is more frequent in children, teenagers, and young adults, but it can also affect older people.
Symptoms and Diagnosis of Osteosarcoma
The most common symptom of osteosarcoma is pain in the diseased bone.
There may also be swelling in the same area.
These symptoms may come and go at first, but over time they tend to persist and worsen.
If a bone tumor is suspected, the doctor will ask a series of questions about the symptoms and perform a physical examination.
To confirm the diagnosis of osteosarcoma, various tests can be performed, including bone X-rays, MRIs, CT scans, bone scans, and PET scans [1].
Bone biopsy is essential to determine whether the bone cells are cancerous.
This procedure is usually carried out by a physician specialized in the treatment of bone tumors.
Treatment of Osteosarcoma
Treatment of osteosarcoma usually involves a combination of surgery, chemotherapy and, in some cases, radiotherapy [1].
Surgery is critical to remove the tumor and must be performed by an orthopedic surgeon specialized in treating bone tumors.
Chemotherapy, in turn, is used to fight cancer cells throughout the body and is administered before and after surgery in treatment cycles, being a fundamental part of the therapy.
Radiation therapy is used in cases where the cancer cannot be completely removed with surgery or to treat symptoms such as pain and swelling when the cancer recurs and further surgery cannot be done.
Side Effects and Follow-up
Surgery, chemotherapy, and radiotherapy can all have side effects, ranging from fatigue and nausea to hair loss and problems in organs such as the kidneys, bladder, or heart [1].
However, there are ways to mitigate and treat most of these side effects.
After treatment completion, it is important to keep visiting your doctor on a regular basis for exams and tests to detect any cancer recurrence and to evaluate late effects of treatment.
These visits may be scheduled less frequently as time goes on.
Life Expectancy for Patients with Osteosarcoma
If osteosarcoma is diagnosed and treated before it has spread outside the area where it began, the 5-year relative survival rate for people of all ages is 76% [2].
If the tumor has spread outside the bone and to surrounding tissues, organs or regional lymph nodes, the 5-year relative survival rate is 64% [2].
If the cancer has spread to distant parts of the body, the 5-year relative survival rate is 24% [2].
These survival data demonstrate that new treatments for osteosarcoma are needed, as it remains an aggressive disease without highly effective therapies.
Clinical Trials Available for Osteosarcoma
There are currently some innovative clinical trials for osteosarcoma patients.
In particular, the Spanish Sarcoma Research Group (GEIS) is the sponsor of the following two clinical trials involving experimental treatments for osteosarcoma:
- ImmunoSarc2: Combination of anti-PD1 immunotherapy nivolumab with chemotherapies for operable high-grade osteosarcoma (primary tumor present with metastases).
- Synergias: Combination of the drug trabectedin with radiotherapy for advanced or metastatic osteosarcoma.
These clinical trials are led by Dr. Javier Martín-Broto, a medical oncologist at the Fundación Jiménez Díaz University Hospital in Madrid.
Regarding these studies in osteosarcoma, Dr. Martín comments:
“These two academic studies bring two innovative strategies for patients with advanced osteosarcoma. The ImmunoSarc2 study seeks to find out whether, as we have observed in other tumors, adding immunotherapy to chemotherapy (CT) can improve the outcomes of CT. Importantly, first-line CT in osteosarcoma has hardly changed in the last decades. Finding a drug that, added to CT, would increase its efficacy would be a major innovation in this field and we are convinced that PD-1 inhibitors, such as nivolumab, can increase the efficacy of anthracyclines and platinum. Moreover, the Synergias trial tests a strategy in bone sarcomas that has shown very positive results in soft tissue sarcomas in terms of disease and symptom control. There is rationale to believe that these results could also be replicated in bone sarcomas.”
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