Emerging innovations and advancements in the field of musculoskeletal oncology

Randall, R. Lor; Theriault, Raminta; Thorpe, Steven W.; Monument, Michael J.

doi:10.1002/jso.27409

Cited by 3 publications

(2 citation statements)

References 43 publications

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“…Musculoskeletal (MSK) oncology is a distinct specialty encompassing the complexities of primary and metastatic bone cancer, soft tissue sarcoma, and benign bone tumors, compounded by the potential for significant treatment and disease-associated morbidity. In recent years, MSK oncology has dramatically evolved, focusing on enhancing patient care through advancements in multimodal management strategies, surgical techniques, medical and pharmacological treatments, patient-reported outcomes, and surveillance protocols [ 1 , 2 ]. While continuing to evolve, the pathologies in MSK oncology pose many challenges in developing clinical evidence for informed decision-making due to the complex manifestations and heterogeneous disease sequelae and their rarity [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Benefit of an Umbrella Protocol: Reducing Challenges in Orthopedic Oncology Research

Simister,

Tse,

Saade

et al. 2024

JCM

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Background: Orthopedic oncology research is hindered by the scarcity of musculoskeletal tumors and research administrative inefficiencies. This paper introduces observational research through an innovative institution-specific methodology—termed an umbrella protocol. This protocol outlines a comprehensive standard procedure to expedite ethical approval for future aligned studies, reducing administrative barriers to research. Methods: We developed an umbrella protocol at an academic center, involving meticulous methodological identification and coordination with the institutional review board (IRB) to adhere to local guidelines. The protocol encompasses identifying investigators, research objectives, study goals, and data and safety monitoring frameworks necessary for typical standards. Results: Implementation of the umbrella protocol took 110 days to achieve exemption status, following multiple discussions with the IRB and extensive revisions. At the authors institution, this protocol significantly reduces protocol review times from an average of six-to-eight weeks to nearly instantaneous, facilitating a streamlined research process. Additionally, we established a dedicated orthopedic oncology patient registry to enhance future research endeavors. Conclusions: The adoption of umbrella protocols represents a pioneering strategy in orthopedic oncology. This approach mitigates research administrative burdens and broadens research scope in the field. It underscores the necessity of IRB collaboration, methodological precision, and stringent data management. The article also reflects on the ethical implications and potential biases introduced by emerging technologies like artificial intelligence, advocating for diligent ethical oversight. The establishment of an umbrella protocol marks a significant step towards more efficient research methodologies, ultimately aiming to improve patient care and outcomes for individuals with rare musculoskeletal conditions.

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Section: Introductionmentioning

confidence: 99%

The Benefit of an Umbrella Protocol: Reducing Challenges in Orthopedic Oncology Research

Simister,

Tse,

Saade

et al. 2024

JCM

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“…(1) outcomes, disparities, and quality of life, emphasizing the transition toward patient-centric outcomes via patient-reported outcome measures (PROMs) and the substantial influence of socioeconomic determinants on health results; (2) surgical management and technological advancements, spotlighting the challenges and innovations in addressing metastatic bone diseases, the advent of 3D custom implants for pelvic bone sarcomas, and the introduction of osseo-integrative devices for amputations; and (3) nonsurgical innovations, elaborating on the significance of treatments like bisphosphonates and denosumab for advanced cancer patients, and the prospective nonsurgical treatments for conditions such as tenosynovial giant cell tumors. 1 In this article for the special edition of "What's New in Surgical Oncology," we provide a review of extremity and truncal soft tissue sarcomas (STS), encompassing updates to their classification, emergent technologies, prognostic and outcome predictions, novel radiation techniques, immunotherapies, and the latest on STS surveillance and disparities in musculoskeletal oncology.…”

Section: Introductionmentioning

confidence: 99%

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Walker,

Simister,

Carr‐Ascher

et al. 2023

Journal of Surgical Oncology

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In this special edition update on soft tissue sarcomas (STS), we cover classifications, emerging technologies, prognostic tools, radiation schemas, and treatment disparities in extremity and truncal STS. We discuss the importance of enhancing local control and reducing complications, including the role of innovative imaging, surgical guidance, and hypofractionated radiation. We review advancements in systemic and immunotherapeutic treatments and introduce disparities seen in this vulnerable population that must be considered to improve overall patient care.

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Supportive care interventions in metastatic bone disease: scoping review

Simister,

Bhale,

Cizik

et al. 2024

BMJ Support Palliat Care

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BackgroundPatients with secondary metastatic involvement of the musculoskeletal system due to primary cancers are a rapidly growing population with significant risks for health-related end-of-life morbidities. In particular, bone metastases or metastatic bone disease (MBD) imparts significant adversity to remaining quality of life. No rigorous review of clinical trials on the use of supportive care interventions for MBD has been conducted. The objective of this review was to examine the characteristics of supportive care interventions for MBD and critically appraise study designs, key findings, and quality of evidence of the research.MethodsWe searched for published clinical trials, systematic reviews and meta-analyses in PubMED, CINAHL and Google Scholar for articles published between September 2017 and September 2022. Some examples of Medical Subject Headings terms were: ‘secondary neoplasm’, ‘metastatic bone disease’, ‘palliative care’ and ‘supportive care intervention’. Quality of published evidence was evaluated based on treatment types and study design.ResultsAfter reviewing 572 publications, 13 articles were included in the final review and evaluation including seven clinical trials, two trial protocols and four systematic reviews. Feasible interventions included enhanced palliative care consultation, palliative radiotherapy and alternative medicines. Interventions addressed primary endpoints of fatigue (N=4, 31%), pain (N=3, 23%) or cancer-related symptoms (N=3, 23%) with patient-reported outcome instruments. No interventions reported on fracture complications or endpoints, specifically. The quality of most studies was moderate to strong.ConclusionSupportive care interventions for MBD are feasible and the impact is measurable via patient-reported outcome measures. While the evidence for interventions was moderate to strong, there are very few specific controlled trials for skeletal-related events and impacts of social determinants of health. Further clinical trials are needed to define supportive care interventions for MBD that demonstrate reduced risk of fracture and that mitigate the reduced quality of life when negative musculoskeletal outcomes arise.

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Emerging innovations and advancements in the field of musculoskeletal oncology

Cited by 3 publications

References 43 publications

The Benefit of an Umbrella Protocol: Reducing Challenges in Orthopedic Oncology Research

The Benefit of an Umbrella Protocol: Reducing Challenges in Orthopedic Oncology Research

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Supportive care interventions in metastatic bone disease: scoping review

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