title: Current status and perspectives regarding the treatment of osteo-sarcoma: chemotherapy.
abstract: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. The use of combination chemotherapy and surgery enables long-term survival in approximately 60-70% of cases. However, the necessity for surgery, the poor prognosis of patients with metastatic or recurrent disease (long-term survival in only about 20% of cases), and the lack of establishment of second-line chemotherapy suggest that improvements in chemotherapy are desperately needed. Currently, in an effort to extend the protocol with the chemotherapy drugs that already exist, high-dose chemotherapy with/without autologous peripheral blood stem cell transplantation, and tumor-targeted drug delivery systems are under investigation. Future drug developments will no doubt lie in the direction of immunotherapy and anti-angiogenic therapy, as well as the use of cytotoxic drugs. Identifying the genes and signal transduction pathways responsible for the development of osteosarcoma or for the occurrence of malignancy in cases of osteosarcoma will undoubtedly lead to the identification of pathway-specific agents, or possible gene therapy. Furthermore, as increased light is shed on the character of osetoblastic differentiation in osteosarcoma, this will certainly give rise to new treatments utilizing differentiation therapy. This article reviews the current status and perspectives regarding the treatment of osteosarcoma in terms of chemotherapy.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Higashi-ku, Maidashi, Fukuoka, 812-8582, Japan. akio@med.kyushu-u.ac.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000293:Adolescent; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D003131:Combined Modality Therapy; D015195:Drug Design; D004358:Drug Therapy / Q000639:trends; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology
references.citation: Curr Opin Rheumatol. 2005 Jan;17(1):79-85
references.pmid: 15604909
references.citation: Clin Orthop Relat Res. 2007 Jan;454:237-46
references.pmid: 17075380
references.citation: Eur J Cancer. 2005 Sep;41(14):2184-95
references.pmid: 16140527
references.citation: Mol Cancer Ther. 2005 Apr;4(4):625-31
references.pmid: 15827336
references.citation: Mol Ther. 2005 Feb;11(2):311-9
references.pmid: 15668143
references.citation: Carcinogenesis. 1993 May;14(5):925-8
references.pmid: 8099316
references.citation: Cancer. 1976 Jan;37(1):1-11
references.pmid: 1082364
references.citation: J Clin Oncol. 1992 Jan;10(1):5-15
references.pmid: 1370176
references.citation: Am J Hum Genet. 1986 Jan;38(1):59-66
references.pmid: 3004203
references.citation: Am J Clin Pathol. 2006 Apr;125(4):555-81
references.pmid: 16627266
references.citation: Expert Rev Anticancer Ther. 2006 Jul;6(7):1075-85
references.pmid: 16831079
references.citation: Cancer Res. 2005 Mar 1;65(5):1748-54
references.pmid: 15753370
references.citation: Cancer Chemother Pharmacol. 1989;24 Suppl 1:S28-9
references.pmid: 2758568
references.citation: Cancer Res. 1993 Nov 15;53(22):5535-41
references.pmid: 8221695
references.citation: Int J Oncol. 2006 Jan;28(1):261-9
references.pmid: 16328004
references.citation: Cancer Treat Rev. 2006 Oct;32(6):423-36
references.pmid: 16860938
references.citation: Pediatr Blood Cancer. 2004 Jan;42(1):46-51
references.pmid: 14752794
references.citation: Cancer Res. 2005 May 1;65(9):3868-76
references.pmid: 15867386
references.citation: Bone Marrow Transplant. 2001 May;27(9):933-7
references.pmid: 11436103
references.citation: Int J Epidemiol. 1997 Apr;26(2):272-8
references.pmid: 9169161
references.citation: J Clin Oncol. 2002 Feb 1;20(3):776-90
references.pmid: 11821461
references.citation: Curr Cancer Drug Targets. 2006 Mar;6(2):123-33
references.pmid: 16529542
references.citation: Pediatr Hematol Oncol. 1992 Apr-Jun;9(2):125-37
references.pmid: 1524989
references.citation: Cancer. 2005 Nov 15;104(10):2214-21
references.pmid: 16206297
references.citation: Cancer Genet Cytogenet. 1997 Jan;93(1):100-6
references.pmid: 9062585
references.citation: Oncology. 2003;65 Suppl 2:99-104
references.pmid: 14586158
references.citation: Clin Orthop Relat Res. 1973 Nov-Dec;(97):64-8
references.pmid: 4521231
references.citation: J Fla Med Assoc. 1979 Jan;66(1):28-30
references.pmid: 283195
references.citation: J Clin Oncol. 2005 Mar 20;23(9):2004-11
references.pmid: 15774791
references.citation: Clin Orthop Relat Res. 1991 Sep;(270):237-46
references.pmid: 1679382
references.citation: Cancer Res. 2005 Mar 15;65(6):2406-11
references.pmid: 15781656
references.citation: J Natl Cancer Inst. 2003 May 7;95(9):669-74
references.pmid: 12734318
references.citation: Bone. 2001 Jan;28(1):104-7
references.pmid: 11165949
references.citation: Int Immunopharmacol. 2002 Jan;2(1):25-38
references.pmid: 11789667
references.citation: Semin Oncol. 2004 Dec;31(6 Suppl 13):53-90
references.pmid: 15717738
references.citation: Cancer Detect Prev. 1999;23(2):129-36
references.pmid: 10101594
references.citation: Expert Rev Anticancer Ther. 2007 Feb;7(2):169-81
references.pmid: 17288528
references.citation: Cancer. 1981 Oct 1;48(7):1569-81
references.pmid: 6945143
references.citation: J Clin Oncol. 1994 Dec;12(12):2614-20
references.pmid: 7989936
references.citation: Cancer. 1982 Mar 15;49(6):1221-30
references.pmid: 6174200
references.citation: Pediatr Blood Cancer. 2004 Nov;43(6):692-7
references.pmid: 15390283
references.citation: Cancer. 1992 Feb 1;69(3):698-708
references.pmid: 1730120
references.citation: Clin Orthop Relat Res. 2002 Apr;(397):40-52
references.pmid: 11953594
references.citation: Pediatr Blood Cancer. 2004 May;42(5):410-5
references.pmid: 15049011
references.citation: Curr Oncol Rep. 2003 Mar;5(2):114-25
references.pmid: 12583828
references.citation: Semin Oncol. 1997 Oct;24(5):561-71
references.pmid: 9344323
references.citation: J Pediatr Hematol Oncol. 2002 Aug-Sep;24(6):440-6
references.pmid: 12218590
references.citation: Cancer. 2003 Dec 1;98(11):2447-56
references.pmid: 14635080
references.citation: Am J Vet Res. 2005 May;66(5):885-91
references.pmid: 15934617
references.citation: Proc Natl Acad Sci U S A. 1987 Nov;84(21):7716-9
references.pmid: 2823272
references.citation: Cancer. 1967 Jun;20(6):967-73
references.pmid: 5229526
references.citation: Chemioterapia. 1988 Apr;7(2):133-7
references.pmid: 3165057
references.citation: J Clin Oncol. 1991 Aug;9(8):1357-62
references.pmid: 2072139
references.citation: Cancer. 2005 Dec 1;104(11):2522-9
references.pmid: 16270320
references.citation: J Bone Miner Res. 2000 Sep;15(9):1766-75
references.pmid: 10976996
references.citation: J Clin Oncol. 2002 Apr 15;20(8):2150-6
references.pmid: 11956277
references.citation: J Clin Oncol. 2003 Feb 15;21(4):710-5
references.pmid: 12586810
references.citation: Eur J Cancer. 2003 Mar;39(4):488-94
references.pmid: 12751380
references.citation: Clin Cancer Res. 2002 Nov;8(11):3584-91
references.pmid: 12429650
references.citation: Clin Orthop Relat Res. 2000 Apr;(373):39-50
references.pmid: 10810461
references.citation: Cancer Invest. 2001;19(3):292-315
references.pmid: 11338887
references.citation: J Biol Chem. 1999 Feb 12;274(7):4266-72
references.pmid: 9933627
references.citation: J Chemother. 2002 Apr;14(2):198-206
references.pmid: 12017378
references.citation: Cancer Treat Rep. 1979 May;63(5):739-51
references.pmid: 313245
references.citation: J Clin Oncol. 2002 Jan 15;20(2):426-33
references.pmid: 11786570