Bone Tumors Committee

The membership of the Bone Tumors committee includes expertise in the following specialties: Pediatric hematology/oncologists, nurses, patient advocate, clinical research associates, biostatisticians, radiation oncologists, radiologists, orthopedic surgeons, thoracic surgeons and pathologists.

Progress

As recently as 20 years ago, the removal of a bone tumor required amputation, and many patients later died of their disease. While amputation is still sometimes necessary, today many patients are able to have limb-salvage surgery – an operation designed to save the limb while removing the tumor, often using a special prostheses.

The rate of progress over the past 15 years has not been as rapid as researchers would like. The medications used treating patients with bone tumors have been available for some time. The following illustrates the plateau in results and CureSearch COG’s challenge is to find improved therapy and new approaches:

Current focus

Identify new drugs (with classic mechanisms of action)

Researchers are looking for new chemotherapy agents that will kill the tumor more effectively. The Bone Tumor committee works with the Developmental Therapeutics Committee to this end.

Other agents

The search is on for other ways to interfere with the growth of the cancer. One example is to interfere with the blood supply of the tumor. There is also great interest in developing therapy that targets the molecutlar pathways important in cancer development including the search for pathways that encourage cancer cells to die.

Translational research

In osteosarcoma, researchers have discovered an instability of the genetic make-up, leading to a wide variation in the number of chromosomes in the cancer cell.  In Ewing sarcoma, a specific alteration is seen, linking two genes together which ordinarily reside on different chromosomes.

In both cases, the abnormalities may further the development of cancer. The study of these abnormalities may also lead to the development of new anti-cancer strategies, leading to a translation of basic science results into the treatment of young bone tumor patients.

Collaboration with veterinary medicine

Although osteosarcoma is uncommon in humans, it is found much more frequently in dogs, especially larger breeds like St. Bernards.  Thus CureSearch COG researchers are working very closely with their veterinary medicine colleagues to find new approaches to treat osteosarcoma.  Veterinary oncologists test new agents in dogs with osteosarcoma and if the strategy appears promising it can then be translated into the treatment of human disease. 

Collaboration with international researchers

Due to the small number of patients each year, and in an effort to find new and improved treatments for these patients, CureSearch COG is increasingly collaborating with European colleagues including researchers in England, Germany, Scandinavia and the Netherlands.  These efforts have lead to collaborations in the management of patients with localized osteosarcoma as well as in the management of patients with metastatic Ewing sarcoma.  These studies will allow the enrollment of a larger number of patients, making it feasible to evaluate the impact of new treatment strategies on these patients. 

Updated February 2009