Osteosarcoma in Pediatric and Adult Populations: Are Adults Just Big Kids?

Abstract

Malignant bone tumors are commonly classified as pediatric or adolescent malignancies, and clinical trials for these diseases have generally focused on these populations. Of primary bone cancers, osteosarcoma is among the most common. Osteosarcoma has a bimodal age distribution, with the first peak occurring in patients from 10 to 14 years old, and the second peak occurring in patients older than 65, with about 25% of cases occurring in adults between 20 and 59 years old. Notably, adult osteosarcoma patients have worse outcomes than their pediatric counterparts. It remains unclear whether age itself is a poor prognostic factor, or if inherent differences in tumor biology exist between age groups. Despite these unknowns, current treatment strategies for adults are largely extrapolated from pediatric studies since the majority of clinical trials for osteosarcoma treatments are based on younger patient populations. In light of the different prognoses observed in pediatric and adult osteosarcoma, we summarize the current understanding of the molecular etiology of osteosarcoma and how it may differ between age groups, hypothesizing why adult patients have worse outcomes compared to children.

Targeting PERK-ATF4-P21 axis enhances the sensitivity of osteosarcoma HOS cells to Mppα-PDT

“…Among primary bone cancers, osteosarcoma is the most common, with a bimodal age distribution of onset, with the first peak occurring in patients aged 10–14 years and the second peak occurring in patients over 65 years, with about 25% of cases occurring in adults aged 20–59 years [ 23 ]. However, the underlying tumor biology of osteosarcoma in children and adults is significantly heterogeneous, including: chromosome instability [ 24 ], abnormal mitotic signaling pathways and cell cycle checkpoints [ 25 ], telomere dysregulation [ 26 ], and miRNA expression [ 27 ] et al Compared to pediatric osteosarcomas, adult osteosarcomas are more likely to be secondary osteosarcomas associated with prior radiation therapy or, in some cases, Paget’s disease (a disorder of bone metabolism characterized by overactivity of bone cells and the formation of bone matrix by osteoblasts in a faster and disordered manner, producing their characteristic “Mosaic” pattern [ 23 ]). Radiation exposure is another cause of secondary osteosarcoma in adults, typically occurring many years after the exposure.…”

Targeting IL-11R/EZH2 signaling axis as a therapeutic strategy for osteosarcoma lung metastases

“…We thank Amy Ninetto, Scientific Editor, and Sarah Bronson, Scientific Editor, of the Research Medical Library, MD Anderson Cancer Center, for editing the manuscript. Figures 3,4,5,7 were put together in Biorender.com.…”

“…Patients with relapsed disease only have a 20% survival rate [3]. Systemic chemotherapy treatment is associated with significant morbidity, including renal failure, cardiac compromise and neuropathy [4,5]. Alternative noncytotoxic targeted therapeutics, including tyrosine kinase inhibitors and insulin-like growth factor-1 inhibitors, have shown limited effectiveness against human OS or are associated with intolerable adverse effects [6][7][8][9][10].…”