scholarly journals Osteosarcoma in Children: Not Only Chemotherapy

2021 ◽  
Vol 14 (9) ◽  
pp. 923
Author(s):  
Maura Argenziano ◽  
Chiara Tortora ◽  
Elvira Pota ◽  
Alessandra Di Paola ◽  
Martina Di Martino ◽  
...  
Keyword(s):  
Chemotherapy Regimen ◽  
High Dose Chemotherapy ◽  
Therapeutic Strategies ◽  
High Rate ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Bone Microenvironment ◽  
Dose Methotrexate ◽  
Novel Therapeutic Strategies ◽  
Novel Therapeutic

Osteosarcoma (OS) is the most severe bone malignant tumor, responsible for altered osteoid deposition and with a high rate of metastasis. It is characterized by heterogeneity, chemoresistance and its interaction with bone microenvironment. The 5-year survival rate is about 67% for patients with localized OS, while it remains at 20% in case of metastases. The standard therapy for OS patients is represented by neoadjuvant chemotherapy, surgical resection, and adjuvant chemotherapy. The most used chemotherapy regimen for children is the combination of high-dose methotrexate, doxorubicin, and cisplatin. Considered that the necessary administration of high-dose chemotherapy is responsible for a lot of acute and chronic side effects, the identification of novel therapeutic strategies to ameliorate OS outcome and the patients’ life expectancy is necessary. In this review we provide an overview on new possible innovative therapeutic strategies in OS.

Ewing Sarcoma: Current Management and Future Approaches Through Collaboration

2015 ◽  
Vol 33 (27) ◽  
pp. 3036-3046 ◽  
Author(s):  
Nathalie Gaspar ◽  
Douglas S. Hawkins ◽  
Uta Dirksen ◽  
Ian J. Lewis ◽  
Stefano Ferrari ◽  
...  
Keyword(s):  
Overall Survival ◽  
Ewing Sarcoma ◽  
High Dose Chemotherapy ◽  
Therapeutic Strategies ◽  
High Dose ◽  
Dismal Prognosis ◽  
Medical Oncologists ◽  
Localized Disease ◽  
The Many ◽  
Novel Therapeutic Strategies

Ewing sarcoma (ES) is an aggressive sarcoma of bone and soft tissue occurring at any age with a peak incidence in adolescents and young adults. The treatment of ES relies on a multidisciplinary approach, coupling risk-adapted intensive neoadjuvant and adjuvant chemotherapies with surgery and/or radiotherapy for control of the primary site and possible metastatic disease. The optimization of ES multimodality therapeutic strategies has resulted from the efforts of several national and international groups in Europe and North America and from cooperation between pediatric and medical oncologists. Successive first-line trials addressed the efficacy of various cyclic combinations of drugs incorporating doxorubicin, vincristine, cyclophosphamide, ifosfamide, etoposide, and dactinomycin and identified prognostic factors now used to tailor therapies. The role of high-dose chemotherapy is still debated. Current 5-year overall survival for patients with localized disease is 65% to 75%. Patients with metastases have a 5-year overall survival < 30%, except for those with isolated pulmonary metastasis (approximately 50%). Patients with recurrence have a dismal prognosis. The many insights into the biology of the EWS-FLI1 protein in the initiation and progression of ES remain to be translated into novel therapeutic strategies. Current options and future approaches will be discussed.

scholarly journals Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

2005 ◽  
Vol 18 (3) ◽  
pp. 556-569 ◽  
Author(s):  
Brad Spellberg ◽  
John Edwards ◽  
Ashraf Ibrahim
Keyword(s):  
Combination Therapy ◽  
Liposomal Amphotericin ◽  
Iron Chelator ◽  
Therapeutic Strategies ◽  
Rapid Diagnosis ◽  
High Dose ◽  
Immunocompromised Patients ◽  
Life Threatening ◽  
Novel Therapeutic Strategies ◽  
Novel Therapeutic

SUMMARY Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. These infections are becoming increasingly common, yet survival remains very poor. A greater understanding of the pathogenesis of the disease may lead to future therapies. For example, it is now clear that iron metabolism plays a central role in regulating mucormycosis infections and that deferoxamine predisposes patients to mucormycosis by inappropriately supplying the fungus with iron. These findings raise the possibility that iron chelator therapy may be useful to treat the infection as long as the chelator does not inappropriately supply the fungus with iron. Recent data support the concept that high-dose liposomal amphotericin is the preferred monotherapy for mucormycosis. However, several novel therapeutic strategies are available. These options include combination therapy using lipid-based amphotericin with an echinocandin or with an azole (largely itraconazole or posaconazole) or with all three. The underlying principles of therapy for this disease remain rapid diagnosis, reversal of underlying predisposition, and urgent surgical debridement.

scholarly journals Bone Microenvironment and Osteosarcoma Metastasis

2020 ◽  
Vol 21 (19) ◽  
pp. 6985 ◽  
Author(s):  
Chaofei Yang ◽  
Ye Tian ◽  
Fan Zhao ◽  
Zhihao Chen ◽  
Peihong Su ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Poor Prognosis ◽  
Therapeutic Strategies ◽  
Bone Microenvironment ◽  
Primary Bone Tumor ◽  
Secondary Tumors ◽  
Primary Bone ◽  
Novel Therapeutic Strategies ◽  
The Relationship ◽  
Novel Therapeutic

The bone microenvironment is an ideal fertile soil for both primary and secondary tumors to seed. The occurrence and development of osteosarcoma, as a primary bone tumor, is closely related to the bone microenvironment. Especially, the metastasis of osteosarcoma is the remaining challenge of therapy and poor prognosis. Increasing evidence focuses on the relationship between the bone microenvironment and osteosarcoma metastasis. Many elements exist in the bone microenvironment, such as acids, hypoxia, and chemokines, which have been verified to affect the progression and malignance of osteosarcoma through various signaling pathways. We thoroughly summarized all these regulators in the bone microenvironment and the transmission cascades, accordingly, attempting to furnish hints for inhibiting osteosarcoma metastasis via the amelioration of the bone microenvironment. In addition, analysis of the cross-talk between the bone microenvironment and osteosarcoma will help us to deeply understand the development of osteosarcoma. The cellular and molecular protagonists presented in the bone microenvironment promoting osteosarcoma metastasis will accelerate the exploration of novel therapeutic strategies towards osteosarcoma.

scholarly journals Ifosfamide/etoposide alternating with high-dose methotrexate: evaluation of a chemotherapy regimen for poor-risk osteosarcoma

1999 ◽  
Vol 79 (7-8) ◽  
pp. 1174-1178 ◽  
Author(s):  
M P Michelagnoli ◽  
I J Lewis ◽  
H R Gattamaneni ◽  
C C Bailey ◽  
L S Lashford
Keyword(s):  
Chemotherapy Regimen ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Poor Risk ◽  
Dose Methotrexate
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