Research in bone cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better ways to treat bone cancer. The following is a selection of research showing promise for treating bone cancer.

We've included information from the following sources. Each item has an identity number that links to a brief overview (sometimes called an abstract).

• PubMed, US National Library of Medicine (PMID)
• ClinicalTrials.gov (NCT)

Chemotherapy uses drugs to treat cancer. It is commonly used to treat bone cancer. Research studies are looking at new chemotherapy drugs and existing chemotherapy drugs and combinations to determine the best treatments for bone cancer. The following is noteworthy research in chemotherapy for bone cancer.

One international trial is comparing the following chemotherapy regimens to treat newly diagnosed Ewing sarcoma (Trials, PMID 31952545).

One regimen is induction chemotherapy with VIDE (vincristine, ifosfamide, doxorubicin and etoposide) followed by consolidation with one of the following:

• VAI (vincristine, dactinomycin and ifosfamide)
• VAC (vincristine, dactinomycin and cyclophosphamide)
• BuMel (busulfan and melphalan hydrochloride)

The other regimen is induction chemotherapy with VDC (vincristine, doxorubicin and cyclophosphamide) and IE (ifosfamide and etoposide) followed by consolidation with one of the following:

• IE
• VC (vincristine and cyclophosphamide)
• VAI
• BuMel

Another trial is also looking at VDC to treat Ewing sarcoma (Pediatric Blood Cancer, PMID 32077253).

Mycophenolate mofetil is an immunosuppressive drug that may be used after organ or stem cell transplants. It is being studied to treat locally advanced or metastatic osteosarcoma (BMC Cancer, PMID 32228535).

Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. Research is looking at new ways to use immunotherapy as a treatment for bone cancer, including the following.

Immune checkpoint inhibitors work by stopping cancer cells from affecting immune system cells in our bodies. The immune system normally stops itself from attacking healthy cells in the body by having some cells make specific proteins called checkpoints. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors are monoclonal antibodies that work by blocking checkpoint proteins so T cells (a type of white blood cell) can attack and kill cancer cells. Researchers are studying the following immune checkpoint inhibitors in early clinical trials to treat advanced bone cancers:

• nivolumab (Opdivo) for osteosarcoma or Ewing sarcoma in young adults and children (Lancet Oncology, PMID 32192573)
• camrelizumab with apatinib for advanced osteosarcoma that progresses after chemotherapy PMID 32377646724 (Journal of Immunotherapy of Cancer, PMID 32376724)
• durvalumab and tremelimumab for advanced or metastatic osteosarcoma (Lancet Oncology, PMID 35934010)
• pembrolizumab for advanced osteosarcoma (European Journal of Cancer, PMID 31442817; Cancer Immunology and Immunotherapy, PMID 33580363)

Targeted therapy uses drugs to target specific molecules (such as proteins) on or inside cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. The following is noteworthy research in targeted therapy for bone cancer.

Kinase inhibitors block a specific enzyme (called a kinase) that helps send signals within cells. When this enzyme is blocked, the cells stop growing and dividing. Researchers are looking at the following kinase inhibitors in treating bone cancer that doesn't respond to other treatments:

• lenvatinib with etoposide and ifosfamide for refractory or relapsed osteosarcoma (Lancet Oncology, PMID 34416158; Future Oncology, PMID 34382412)
• anlotinib, vincristine and irinotecan for advanced Ewing sarcoma (Oncologist, PMID 33611805)
• apatinib with camrelizumab for advanced osteosarcoma that progresses after chemotherapy (Journal of Immunotherapy of Cancer, PMID 32376724)
• cabozantinib for advanced Ewing sarcoma or osteosarcoma (Lancet Oncology, PMID 32078813)
• regorafenib for metastatic osteosarcoma (Journal of Clinical Oncology, PMID 31013172)
• apatinib for advanced osteosarcoma (BMC Cancer, PMID 33892656; Oncologist, PMID 30559126)

PARP inhibitors are drugs that slow or stop a protein called poly (ADP-ribose) polymerase, which helps cells repair DNA damage. Researchers are studying the following PARP inhibitors for the treatment of refractory or recurrent bone cancers:

• niraparib with temozolomide or irinotecan (Cancer, PMID 33289920)
• talazoparib with temozolomide in children and teens with refractory or recurrent Ewing sarcoma (Pediatric Blood Cancer, PMID 31724813)

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is commonly used to treat bone cancer. The following is noteworthy research in radiation therapy for bone cancer.

Combined ion-beam radiation therapy (CIBRT), or hadrontherapy, is a type of radiation therapy that uses protons and carbon ions to treat bone cancer that can't be removed with surgery. Using both protons and carbon ions appears to be effective at treating bone cancer (Radiotherapy and Oncology, PMID 33549644).

Escalated dose radiation therapy (EDRT) involves using PET-CT imaging to identify tumour areas that are more active or at greater risk of recurrence and give an extra boost of radiation to these areas. Research studies show that EDRT improved outcomes for surgically unresectable Ewing sarcoma (International Journal of Radiation, Oncology, Biology and Physics, PMID 35568246).

Researchers continue to try to find out more about cancer. Clinical trials are research studies that test new ways to treat cancer. They also look at ways to prevent, find and manage cancer.

Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for cancer were first shown to be effective through clinical trials.

Find out more about clinical trials.