Osteosarcoma - Childhood and Adolescence: Latest Research

Approved by the Cancer.Net Editorial Board, 11/2016

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu.

Doctors are working to learn more about osteosarcoma, how to best treat it, and how to provide the best care to children and teens diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your child’s doctor about the diagnostic and treatment options best for your child.

  • Improved detection. There are 2 types of imaging tests being studied that may improve the detection of metastases: total-body MRI and PET scans. These tests are described in the Diagnosis section. These tests can suggest the presence of metastatic disease. However, other tests would be needed to confirm this suggestion. Specialists familiar with using these tests must interpret the results of the images. A biopsy may also be needed.

  • Improved treatment. In several studies, researchers are looking at adding different drugs to standard treatment that may improve the treatment’s success without increasing the side effects.

    • A drug that is currently being tested is the immunotherapy drug called mifamurtide (Mepact). Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. Mifamurtide is currently licensed in Europe by the European Medicines Association for the treatment of localized osteosarcoma that can be removed with surgery. However, it has not been approved by the FDA in the United States because the agency feels more research is needed to prove the drug’s effectiveness. Other approaches to stimulate the patient’s own immune system are in the early stages of research.

    • As part of the Children’s Oncology Group AOST 0331 study, pegylated interferon alpha (multiple brand names) was added to treatment after 8 months of chemotherapy. This study was done with patients who have localized osteosarcoma or metastases to the lungs or bones that can be surgically removed and whose tumor was almost completely eliminated by the first 10 to 12 weeks of chemotherapy treatment. The early results of this study showed that adding pegylated interferon alpha did not benefit these patients. More information will become available as patients are followed for a longer time.

    • In the same study (AOST 0331), etoposide (Toposar, VePesid) and ifosfamide (Ifex) were added to treatment after surgery for a total of 10 months of treatment instead of the standard 8 months. This study was done with patients when the osteosarcoma did not respond well to the first treatment. According to the results of this study, adding these drugs after surgery caused more side effects and did not improve the outcome of treatment. Therefore, the more intensive chemotherapy is not recommended.

      The Children’s Oncology Group considers this combination to be standard treatment: cisplatin (Platinol), doxorubicin (Adriamycin), and high-dose methotrexate (multiple brand names). Other combination therapies are similarly effective, but none of them is better. 

    • A study of patients with metastatic disease has also been completed. The study added a bone-stabilizing drug called zoledronic acid (Zometa) to standard chemotherapy. It showed that this combination of treatments did not increase general side effects, which was the goal of the study. A French group studied whether the addition of zoledronic acid to chemotherapy for newly diagnosed patients with osteosarcoma would improve the outcome of treatment. Half of the patients received a standard chemotherapy treatment and surgery. The other half received zoledronic acid in addition to the standard treatment. The group that received zoledronic acid did not have additional improvements. 

  • Palliative or supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current osteosarcoma treatments to improve patients’ comfort and quality of life.

For information about these and other studies, visit the Children’s Oncology Group website or the U.S. National Institutes of Health website. There are also clinical trials using new drugs for people with recurrent osteosarcoma. These studies include patients in whom cancer has come back a first, second, or subsequent time; there is local or distant recurrence; and the recurrence is located in the lungs, other bones, or both.

Talk with your child’s doctor for more information about clinical trials. Your doctor can provide additional details about the availability of these diagnostic tests or treatments or others that are being studied. Also, your doctor can provide details on whether they are appropriate for your child.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding osteosarcoma, explore these related items that will take you outside of this guide:

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