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Proceedings of the Think Tank for Osteosarcoma Medical Advisory Board
Sant P Chawla1, Brian VAN Tine2, Noah Federman3
1Sarcoma Oncology Research Center, Santa Monica, CA, U.S.A.
Abstract:
A "Think Tank for Osteosarcoma" medical advisory board meeting was held in Santa Monica, CA, USA on February 2-3, 2024. The goal was to develop a strategic approach to prevent recurrence of osteosarcoma. Osteosarcoma metabolism and the genomic instability of osteosarcoma, immunotherapy for osteosarcoma, CAR-T cell therapy, DeltaRex-G tumor-targeted gene therapy, repurposed drugs, alternative medicines, and personalized medicine were discussed. Only DeltaRex-G was voted on. The conclusions were the following: No intervention has been demonstrated to improve survival in a clinical trial. Additionally, the consensus (10/12 in favor) was that DeltaRex-G without immunotherapy may be administered for up to one year. Phase 2/3 randomized studies of DeltaRex-G should be performed to determine whether the incidence of recurrence could be reduced in high-risk individuals. Furthermore, a personalized approach using drugs with minimal toxicity could be attempted with the acknowledgement that there are no efficacy data to base this on. Repurposed drugs and alternative therapies should be tested in mouse models of osteosarcoma. Moreover, unmodified IL-2 primed Gamma Delta (NK) cell therapy may be used to prevent recurrence. Lastly, rapid development of CAR-T cell therapy is recommended, and an institute dedicated to the study of osteosarcoma is needed.
Insights
Preventing osteosarcoma recurrence is the focus. DeltaRex-G gene therapy may be used for up to one year, but further trials are needed. Personalized medicine and cell therapies also show promise for osteosarcoma treatment.
Area of Science:
- Oncology
- Genetics
- Immunotherapy
Background:
- Osteosarcoma recurrence remains a significant challenge in patient outcomes.
- Current treatment strategies lack proven methods to consistently prevent disease recurrence.
- A medical advisory board convened to strategize novel approaches for osteosarcoma recurrence prevention.
Purpose of the Study:
- To develop a strategic approach for preventing osteosarcoma recurrence.
- To evaluate various therapeutic modalities including gene therapy, immunotherapy, and personalized medicine.
- To identify promising interventions for future clinical investigation.
Main Methods:
- Discussion and consensus-building among experts on osteosarcoma metabolism, genomic instability, and treatment options.
- Focused voting on the potential use of DeltaRex-G tumor-targeted gene therapy.
- Exploration of CAR-T cell therapy, repurposed drugs, alternative medicines, and personalized medicine.
Main Results:
- No intervention has demonstrated improved survival in clinical trials for osteosarcoma recurrence.
- A consensus (10/12) supported the use of DeltaRex-G without immunotherapy for up to one year.
- Phase 2/3 randomized studies of DeltaRex-G are recommended to assess recurrence reduction in high-risk patients.
Conclusions:
- DeltaRex-G holds potential for recurrence prevention, warranting further clinical validation.
- Personalized medicine approaches and cell-based therapies (IL-2 primed Gamma Delta (NK) cells, CAR-T) show promise.
- Further research, including testing repurposed drugs and alternative therapies in preclinical models, is essential. An institute dedicated to osteosarcoma research is needed.
