In a recent article in the Journal of Bone and Joint Surgery, Francis Hornicek et al. summarized recent advances in the treatment of malignant musculoskeletal tumors reported from August 2013 to October 2014.
Tumors reviewed include:
Chondrosaroma – role of transcription factor ETV5 was highlighted. Other areas being investigated include microRNA 145, osteoclast activity, LDH-A inhibition and conditional survival.
Chordoma – T transcription factor may be important in pathophysiology of this rare tumor
Osteosarcoma – Glucose metabolism continues to be a ripe area of research. Expression of Glut-1 (glucose transporter) has been linked to a worse prognosis. Chimeric antigen receptor (CAR) therapies are being explored. Lee et al. showed a 2.1% risk of developing a secondary malignancy after being treated for osteosarcoma. The use of fluorescence-guided surgery (FGS) and mid therapy PET scans are being investigated.
Ewing Sarcoma – Aneuploidy is common in Ewing’s and absence of STAG2 gene is found in 17-21% of Ewing’s samples and is associated with a more aggressive tumor type.
Soft Tissue Sarcomas – Tumor necrosis rate in soft tissue sarcomas is not linked to prognosis which is different than what has been clearly demonstrated with bone sarcomas. Chest CT was compared to chest radiograph and was found to be equal in evaluating clinically significant pulmonary disease. Self exam of local tumor site makes MRI of limited to no utility when the area can be easily examined.
Find more details in the attached copy of the manuscript
