Pictured: Alexander Chou Pediatric oncologist Alexander Chou is part of the multidisciplinary team caring for young sarcoma patients.

Approximately 400 children, adolescents, and young adults up to age 40 in the United States are diagnosed with osteosarcoma each year. This type of tumor arises in the bone, and often causes pain and swelling in the affected area.

While any of the body's 206 bones can be affected, 50 percent of young patients have tumors that develop near the knee.

Diagnosis

When our doctors suspect that a child, adolescent, or young adult has osteosarcoma, the diagnosis is confirmed using x-rays, CT scans, MRI, and a biopsy of the affected tissue performed under general anesthesia.

Because osteosarcoma can spread widely throughout the body, our experts perform imaging studies such as chest CT scans and bone scans to determine how far the tumor has spread.

Treatment

Children with osteosarcoma are treated with intensive chemotherapy to shrink the tumor and to prevent new tumors from forming. Standard chemotherapy medications for osteosarcoma include cisplatin, doxorubicin, and high-dose methotrexate. Our doctors led a pilot study showing that giving the drug dexrazoxane to patients with newly diagnosed osteogenic sarcoma can help protect damage to the heart, which can occur as a result of treatment with doxorubicin.(1)

In addition, a large study chaired by a Memorial Sloan Kettering investigator has shown that survival may improve when the biological agent muramyl tripeptide is added to chemotherapy.(2) This drug, though approved in Europe, has not been approved by the US Food and Drug Administration.

Our experts also perform surgery to remove the tumor.

Treatment for Recurrent or Metastatic Osteosarcoma

In the rare case that a child’s tumor returns or spreads to other areas of the body, treatment could include surgery, radiation therapy, and chemotherapy agents that may not have been used previously. Your child may also be eligible for innovative therapies through clinical trials.

The most common area for recurrence of osteosarcoma is the lungs. We are testing the use of an inhaled therapy for patients with osteosarcoma that has returned in the lung. We are giving the chemotherapy agent cisplatin encased in small particles called liposomes as an aerosol spray.

This allows us to deliver a high concentration of cisplatin to the lungs with almost no exposure to the rest of the body, avoiding the common side effects of the drug, which include the risk of hearing loss and kidney damage.

We are also testing the use of an immune system therapy against osteosarcoma that has spread to another area of the body. We are using a highly purified, monoclonal antibody against a protein known as the GD2 antigen, which is found on the surface of almost all osteosarcoma tumor cells.

This specific antibody therapy has made a significant difference in the treatment of neuroblastoma, a different tumor that affects children. Our experts hope to learn whether the antibody can similarly benefit young patients with osteosarcoma.