Cancer Biology and Evolution Program, Adolescent and Young Adult Oncology Program, Department of Interdisciplinary Cancer Management and Sarcoma Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Department of Pediatrics, U.T. MD Anderson Cancer Center, Houston, TX, USA.
Adv Exp Med Biol. 2020;1257:85-94. doi: 10.1007/978-3-030-43032-0_8.
Osteosarcoma relapses not only herald a very poor prognosis but also opportunities to treat this genetically diverse complex cancer in new ways. This review will attempt to show that the field is a rapidly evolving one in which not only cytotoxic agents but also local control strategies and the immune system can be harnessed to improve the prognosis of relapsed patients. The molecular heterogeneity and the difficulty of effectively treating most common patterns of relapse with surgery and/or radiation (lung and/or bone metastases) have been responsible for a wide variety of approaches to learning whether agents are active against osteosarcoma. This chapter will highlight past, current, and potential future approaches to provide more effective systemic therapy for the problem of recurrent metastases of osteosarcoma. These include single-agent trials with a wide variety of agents, radiopharmaceuticals, and immune therapies. Finally, how such efforts are integrated into more effective local control strategies is also discussed.
骨肉瘤的复发不仅预示着预后非常差，而且也为以新的方式治疗这种遗传上多样化的复杂癌症提供了机会。本综述将试图表明，该领域是一个快速发展的领域，不仅细胞毒性药物，而且局部控制策略和免疫系统都可以被利用来改善复发患者的预后。分子异质性以及用手术和/或放射治疗（肺和/或骨转移）有效治疗大多数常见复发模式的困难，导致了广泛的方法来研究药物是否对骨肉瘤有效。这一章将重点介绍过去、现在和潜在的未来方法，为骨肉瘤复发性转移的问题提供更有效的全身治疗。这些方法包括使用各种药物、放射性药物和免疫疗法的单一药物试验。最后，还讨论了如何将这些努力整合到更有效的局部控制策略中。
