Current Insights into the Management of Late Chemotherapy Toxicities in Pediatric Osteosarcoma Patients

Abstract

With ever increasing long-term, disease free survival rates, long-term toxicities of otherwise successful therapy have gained increasing importance. They can be grouped into potentially life-threatening, especially secondary malignancies and anthracycline cardiomyopathies, potentially disabling, particularly severe hearing loss and renal insufficiency, other, and rare events. Pathophysiology, frequency, and medical treatment approaches are discussed. Finally, fertility issues and quality of life issues are discussed, together with an outlook into the future. The challenge to cure as many patients as possible from osteosarcoma while enabling a life free of late effects will remain.

Keywords:

• osteosarcoma
• child
• adolescent
• chemotherapy
• late effects

Acknowledgments

We are indebted to all former and present osteosarcoma patients who helped us learn about late therapy toxicities.

Disclosure

Stefanie Hecker-Nolting report that her institution received financial support from EISAI. Thorsten Langer, and Claudia Blattmann report no conflicts of interest. Leo Kager reports financial compensation for advisory board roles for Bayer, Novartis, Amgen, and Agios, outside of the scope of this work. Stefan S Bielack reports financial compensation for advisory board roles for Bayer Healthcare, Boehringer Ingelheim, Hoffmann-La Roche, Ipsen, Eli Lilly, and Sensorion, all outside of the scope of this work. The authors report no other conflicts of interest in this work.