Therapy for osteosarcoma: Where do we go from here?

被引：276

作者：

Chou A.J. ^{[1
]}

Geller D.S. ^{[2
]}

Gorlick R. ^{[3
,4
]}

机构：

[1] Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY

[2] Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY

[3] Department of Pediatrics, Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Bronx, NY

[4] Department of Pediatrics, Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Bronx, NY 10467, 3415 Bainbridge Avenue, Rosenthal

来源：

Pediatric Drugs | 2008年 / 10卷 / 5期

关键词：

Adolescents; Cediranib; therapeutic use; Children; Cisplatin; Deforolimus; Doxorubicin; Etoposide; Granulocyte macrophage colony stimulating factors;

D O I：

10.2165/00148581-200810050-00005

中图分类号：

学科分类号：

摘要：

Osteosarcoma is the most common malignant primary bone tumor in children and adolescents. Current optimal treatment for osteosarcoma consists of multi-agent chemotherapy and aggressive surgical resection of all sites of disease involvement. The current national and international cooperative trial for patients with newly diagnosed osteosarcoma builds upon the backbone of cisplatin, doxorubicin, and methotrexate. This protocol is designed to clarify whether (i) the addition of ifosfamide and etoposide to postoperative chemotherapy with cisplatin, doxorubicin, and methotrexate improves the event-free survival and overall survival for patients with resectable osteosarcoma and a poor histologic response to 10 weeks of preoperative chemotherapy; and (ii) the addition of pegylated interferon-α-2b as maintenance therapy after postoperative chemotherapy with cisplatin, doxorubicin, and methotrexate improves the event-free survival and overall survival for patients with resectable osteosarcoma and a good histologic response to 10 weeks of preoperative chemotherapy. However, the optimal treatment strategy (or strategies) for patients with relapsed or metastatic disease has yet to be defined. This remains one of the persistent challenges in the treatment of osteosarcoma. Recent therapeutic advances have focused on circumventing chemotherapy resistance mechanisms, incorporation of non-classical agents into upfront therapy, targeting of the tumor micro-environment, and investigating the role of novel delivery mechanisms. In patients with localized disease the 5-year survival rate is at least 70%; patients with metastatic or recurrent disease have <20% chance of long-term survival despite aggressive therapies. These figures have changed little in the past 2 decades. This review focuses on the current therapy for osteosarcoma, and highlights emerging strategies that will hopefully change the outlook for patients with this disease. © 2008 Adis Data Information BV. All rights reserved.

引用

页码：315 / 327

页数：12

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