Advances in immune checkpoint inhibitors for bone sarcoma therapy.

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Abstract

13. Cancer. 2017 Jun 15;123(12):2206-2218. doi: 10.1002/cncr.30589. Epub 2017 Mar 21. Treatment pathway of bone sarcoma in children, adolescents, and young adults. Reed DR(1)(2)(3), Hayashi M(4), Wagner L(5), Binitie O(1)(3)(6), Steppan DA(4), Brohl AS(1)(2), Shinohara ET(7), Bridge JA(8), Loeb DM(4), Borinstein SC(9), Isakoff MS(10). Author information: (1)Sarcoma Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. (2)Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. (3)Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. (4)Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland. (5)Division of Pediatric Hematology/Oncology, University of Kentucky, Lexington, Kentucky. (6)Department of Orthopedic Surgery, University of South Florida College of Medicine, Tampa, Florida. (7)Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee. (8)Department of Pathology and Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, Nebraska. (9)Division of Pediatric Hematology-Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee. (10)Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut. When pediatric, adolescent, and young adult patients present with a bone sarcoma, treatment decisions, especially after relapse, are complex and require a multidisciplinary approach. This review presents scenarios commonly encountered in the therapy of bone sarcomas with the goal of objectively presenting a consensus, multidisciplinary management approach. Little variation was found in the authors' group with respect to local control or systemic therapy. Clinical trials were universally prioritized in all settings. Decisions regarding relapse therapies in the absence of a clinical trial had very minor variations initially, but a consensus was reached after a literature review and discussion. This review presents a concise document and figures as a starting point for evidence-based care for patients with these rare diseases. This framework allows prospective decision making and prioritization of clinical trials. It is hoped that this framework will inspire and focus future clinical research and thus lead to new trials to improve efficacy and reduce toxicity. Cancer 2017;123:2206-2218. © 2017 American Cancer Society. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. DOI: 10.1002/cncr.30589 PMCID: PMC5485018