Advances in emerging drugs for osteosarcoma

Abstract

Introduction: Osteosarcoma (OS), the most common primary malignant bone tumor, is currently treated with pre- and postoperative chemotherapy in association with the surgical removal of the tumor. Conventional treatments allow to cure about 60 – 65% of patients with primary tumors and only 20 – 25% of patients with recurrent disease. New treatment approaches and drugs are therefore highly warranted to improve prognosis.

Areas covered: This review focuses on the therapeutic approaches that are under development or clinical evaluation in OS. Information was obtained from different and continuously updated data bases, as well as from literature searches, in which particular relevance was given to reports and reviews on new targeted therapies under clinical investigation in high-grade OS.

Expert opinion: OS is a heterogeneous tumor, with a great variability in treatment response between patients. It is therefore unlikely that a single therapeutic tool will be uniformly successful for all OS patients. This claims for the validation of new treatment approaches together with biologic/(pharmaco)genetic markers, which may select the most appropriate subgroup of patients for each treatment approach. Since some promising novel agents and treatment strategies are currently tested in Phase I/II/III clinical trials, we may hope that new therapies with superior efficacy and safety profiles will be identified in the next few years.

Keywords:

• drug resistance
• osteosarcoma
• pharmacogenetics
• pharmacogenomics
• tailored therapy
• targeted drugs

Declaration of interest

The own studies and unpublished observations cited in this review were supported by grants from the Italian Association for Cancer Research (Associazione Italiana per la Ricerca sul Cancro, A.I.R.C.; grants to Massimo Serra), Istituto Ortopedico Rizzoli (5xmille contributions to the Rizzoli Institute), the European Project KCK (Kids Cancer Kinome; grant No.037390) and the European Network of Excellence EuroBoNeT (grant LSHC-CT-2006-018814). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.