male patient with osteosarcoma talks to nurse

The treatment options for osteosarcoma, a form of bone cancer, have expanded greatly in recent years, providing a new source of hope to many patients. The optimal treatment approach for osteosarcoma can vary based on the location, size and stage of the tumor and the patient’s overall health and preferences.

For localized disease, the combination of surgery with chemotherapy administered both before and after surgery can potentially result in a cure. In less aggressive forms, surgery alone may be sufficient. Because the condition is relatively rare, it is important to seek guidance from a multispecialty team at a high-volume cancer center, where the physicians have abundant opportunities to develop extensive and refined expertise in treating osteosarcoma and to develop patient-specific treatment plans.

Surgery for osteosarcoma

Surgery often plays a crucial role in the comprehensive management of osteosarcoma. The primary goal of surgical treatment is to remove the tumor in its entirety while preserving as much healthy bone and surrounding tissue as possible.

Limb-sparing surgery, a common approach, involves removing the cancerous bone segment and replacing it with a prosthesis or a bone graft. In localized cases, limb-sparing surgery may be an option for removing the tumor and preserving function. This technique aims to preserve overall quality of life. In cases where limb salvage is not feasible due to the size or location of the tumor, amputation may be considered.

Chemotherapy for osteosarcoma

Along with surgery, chemotherapy is often a key component of osteosarcoma treatment. Chemo may be administered:

Before surgery to shrink the tumor, make it easier to remove and increase the likelihood of a successful limb-sparing procedure
After surgery to target any remaining cancer cells and help prevent a recurrence

Some chemotherapy drugs that are commonly used for osteosarcoma treatment include doxorubicin, cisplatin and methotrexate. The specific chemo regimen can vary based on the extent of cancer spread and the patient’s age and overall health. A combination of surgery and chemotherapy can significantly improve the outcome and quality of life for many patients with osteosarcoma, increasing the likelihood of long-term cancer control and survival.

Radiation therapy for osteosarcoma

While surgery and chemotherapy are the mainstays of osteosarcoma treatment, radiation therapy is used less frequently. The main reason is that osteosarcoma is relatively radioresistant, which means it tends to respond to radiation therapy less favorably than other tumors. As a result, radiation therapy is not commonly used as the primary form of treatment for this type of bone cancer.

With that said, radiation therapy may be considered for osteosarcoma if:

Surgical treatment is not feasible
The tumor cannot be removed in its entirety
Cancerous cells remain in nearby tissues after surgery

The decision to use radiation therapy is usually made on a case-by-case basis, and the potential benefits must be carefully weighed against the risks and side effects.

Immunotherapy for osteosarcoma

Currently, no immunotherapy has proven to be effective in treating osteosarcoma. Scientists have determined that this type of bone cancer has a complex immunosuppressive tumor microenvironment, which poses challenges for immune system activation.

Through ongoing research and clinical trials, scientists and clinicians continue to explore the potential of immunotherapy in treating osteosarcoma. For example, immunotherapeutic approaches such as immune checkpoint inhibitors and adoptive T-cell therapies are being investigated as ways to enhance the body’s immune response against osteosarcoma cells.

Targeted therapy for osteosarcoma

Targeted therapy for osteosarcoma involves using drugs that specifically target certain molecules involved in the growth and spread of the cancer cells. Unlike chemotherapy, which affects both cancerous cells and healthy cells, targeted therapy aims to interfere only with the specific proteins or pathways associated with the cancer. As such, the risk of disruptive treatment side effects is reduced.

One targeted therapy approach for osteosarcoma involves focusing on the vascular endothelial growth factor (VEGF) pathway. Drugs that inhibit VEGF, such as bevacizumab, can potentially disrupt the blood supply to an osteosarcoma tumor and impede its growth.

Another target is insulin-like growth factor 1 receptor (IGF-1R), which plays a role in the development and progression of osteosarcoma. In clinical trials, researchers are investigating drugs that can potentially block IGF-1R to inhibit tumor growth.

While targeted therapy holds promise for treating osteosarcoma, its effectiveness can vary among individuals, and not all patients may benefit. As the field evolves, consultation with a healthcare professional or participation in a clinical trial may provide a patient with access to the latest and most effective targeted therapies for osteosarcoma treatment.

Clinical trials for osteosarcoma

Clinical trials play a crucial role in helping scientists and clinicians advance their understanding of osteosarcoma and develop innovative treatment approaches. These important research studies aim to evaluate promising new therapies, improve existing treatments and enhance overall patient outcomes. Some key aspects of clinical trials for osteosarcoma include:

Novel therapies – Trials often explore the efficacy of new drugs that may offer improved outcomes compared to the current standard of care.
Treatment combinations – Trials may investigate the effectiveness of combining different treatment approaches, such as surgery, chemotherapy and targeted therapy, to enhance the overall effectiveness of treatment.
Precision medicine – Some trials focus on personalized or precision medicine, which involves tailoring treatments to the specific genetic characteristics of the tumor to improve the therapeutic response.
Pre- and post-surgical approaches – Clinical trials may assess the benefits of administering certain treatments such as chemotherapy before or after surgery to improve the outcome.
Quality of life studies – In addition to treatment-focused trials, research may address survivorship and quality of life issues for patients who have undergone osteosarcoma treatment.

Frequently asked questions (FAQs) about osteosarcoma treatment

The following FAQs-related articles provide additional information about osteosarcoma treatment:

Benefit from world-class care at Moffitt Cancer Center

In the renowned Sarcoma Program at Moffitt, our multispecialty team practices precision medicine, tailoring a treatment strategy for each patient based on their individual characteristics, needs and goals. Because Moffitt is a high-volume cancer center, our team has unrivaled experience in providing all types of osteosarcoma treatment. We also offer a full range of supportive care services to help our patients achieve the best possible quality of life during osteosarcoma treatment and beyond.

Medically reviewed by Dr. Alexander Lazarides

You can request an appointment with a specialist in our Sarcoma Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

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