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A Deep Dive Into the Newest Avenues of Immunotherapy for Pediatric Osteosarcoma: A Systematic Review

Megha Suri1, Nitin Soni2, Nkiruka Okpaleke3

  • 1Medicine-Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Cureus
|November 2, 2021
PubMed

Insights

Immunotherapy shows promise for pediatric osteosarcoma (OS), particularly when combined with standard treatments. Further research is needed to fully understand its impact and safety in children with this rare bone cancer.

Area of Science:

  • Oncology
  • Immunology
  • Pediatric Medicine

Background:

  • Osteosarcoma (OS) is a primary bone cancer prevalent in children and young adults.
  • Current treatments (surgery, chemotherapy) offer limited improvement for localized OS.
  • Advanced, metastatic, or recurrent OS often resists chemotherapy, necessitating novel therapies.

Purpose of the Study:

  • To systematically review immunotherapy's role in improving clinical outcomes for pediatric OS.
  • To summarize preclinical and clinical research on immunotherapy for pediatric OS.
  • To explore the influence of the immune system on OS progression and metastasis.

Main Methods:

  • Systematic review of 27 articles and clinical trials involving 785 OS participants (243 pediatric).
  • Searched PubMed, PubMed Central, and ClinicalTrials.gov.
  • Assessed article quality using AMSTAR and Cochrane risk-of-bias tools.

Main Results:

  • Immunotherapy, especially immune checkpoint inhibitors combined with chemotherapy and surgery, shows potential for pediatric OS.
  • The bimodal distribution of OS complicates precise effect estimation and adverse event assessment.
  • Current studies have limitations in precisely estimating overall effects and potential life-threatening adverse events in children.

Conclusions:

  • Immunotherapy offers a promising avenue for treating pediatric osteosarcoma.
  • Combining immunotherapies with established treatments may enhance outcomes.
  • More extensive multinational clinical trials focused on pediatric patients are essential to fully evaluate immunotherapy's efficacy and safety.
Keywords:
car timmune checkpoint therapyimmunoeditingimmunotherapymesenchymal stem cells (mscs)nk cellosteosarcomatumor immune microenvironment

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