Systemic strategies for osteosarcoma: advances and future directions

Osteosarcoma is a common and aggressive bone cancer in children and adolescents, typically affecting the long bones during growth spurts. Treatment involves a combination of surgery, chemotherapy, and radiotherapy. Although surgery has become more limb-preserving, the overall prognosis remains challenging, with a 5-year survival rate of 60-70% for localized disease and much lower for advanced stages. Chemotherapy is the mainstay treatment; however, it can cause severe side effects. Targeted therapies (e.g., IGF-1R inhibitors, TKIs) and immunotherapy (e.g., checkpoint inhibitors, CAR-T therapies) are promising areas of research that aim to attack cancer cells more precisely with lower toxicity. Other novel approaches, such as gene therapy and drug delivery systems, are being explored. With continued research and development of new therapies, we hope to significantly improve the outlook of patients with osteosarcoma in the future.