Osteosarcoma Research: A Multidisciplinary Approach

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Osteosarcome tumours will be facing a war on two fronts as researchers and physicians at Mount Sinai Hospital combine their knowledge and expertise in the hopes of developing targeted therapeutic strategies for patients.

This multidisciplinary approach is a change from the idea of researchers and physicians working in isolation.

Osteosarcoma is a cancerous bone tumour that primarily affects children and young adults. Osteosarcoma usually develops from osteoblasts, the cells that develop growing bone, and most commonly presents in teenagers who are experiencing growth spurts. There are a variety of treatment options available to osteosarcoma patients that include chemotherapy and surgery, however, these tumours often go through significant genetic alterations that limit the effectiveness of chemotherapy and often result in high rates of recurrence.

The genetic alterations that occur in osteosarcoma tumours is what prompted doctors Irene Andrulis, a researcher at Mount Sinai’s Samuel Lunenfeld Research Institute, Dr. Jay Wunder, Head of Orthopaedic Surgery and a Researcher at Mount Sinai and Dr. Robert Bell, the new President and CEO of the University Health Network and an oncology surgeon at Mount Sinai Hospital, to study the genetic profiles of osteosarcoma. The study began as part of Dr. Wunder’s thesis research in 1988. Together with a multidisciplinary team of orthopaedic oncologists, pathologists, statisticians and physiotherapists, they set out to determine what causes the genetic alterations to occur, therefore allowing the development of targeted chemotherapy treatment.

“This is the first time a study of this kind has been conducted on osteosarcoma in Canada,” says Dr. Andrulis. “By implementing a multidisciplinary approach we are able to use a wider variety of resources and expertise that will hopefully produce more comprehensive results, which will have a direct impact on clinical treatment plans for patients.”

Exploration of the genetic alterations in osteosarcoma tumours will allow for the development of targeted therapeutic strategies which researchers hope will result in a lower rate of recurrence of the condition.

The study, which compares the genetic make-up of osteosarcoma tumours, involves more than 300 patients. Researchers are examining tumours from patients who have experienced a recurrence and tumours from patients who were cured – meaning they have been disease-free for a minimum of three years. The study will compare gene signatures and will also attempt to determine chemotherapy resistance pathways in order to identify therapeutic targets leading to individualized treatment for patients. The tumour specimens were collected as part of an international, multi-centre osteosarcoma tumour bank with corresponding clinical data that was established for molecular epidemiological studies. Because osteosarcoma tumours are relatively rare, the osteosarcoma tumour bank was used to provide a greater research sample, thereby increasing statistical accuracy.

“The outcome for people with osteosarcoma had not changed,” says Dr. Andrulis. “This study is a unique opportunity to improve our understanding of the genetic complexity of osteosarcoma, which will lead to the improvement of treatment for patients.”