Osteosarcoma is the most common primary bone cancer, predominantly affecting children and young adults during growth spurts. Intensive chemotherapy combined with limb-sparing surgery cures about 70% of patients with localized disease, but metastatic and relapsed osteosarcoma remains very difficult to treat.
What's actually going on in research
Immune checkpoint inhibitors and adoptive T-cell therapies are being tested for metastatic and relapsed osteosarcoma, where new systemic options are desperately needed. Antibody-drug conjugates targeting GD2, which is expressed on osteosarcoma cells, are entering clinical trials. Muramyl tripeptide (mifamurtide), which activates the immune system against bone cancer, is approved outside the US and being studied in combination regimens.
GD2-targeted therapy
GD2 is expressed on the surface of osteosarcoma cells; antibodies, antibody-drug conjugates, and CAR-T cells targeting GD2 are in trials for relapsed and metastatic disease.
Checkpoint immunotherapy
PD-1 and CTLA-4 inhibitors have limited single-agent activity in osteosarcoma but are being combined with anti-angiogenic drugs and other immunomodulators in trials.
Aerosol chemotherapy
Inhaled gemcitabine and other agents are being developed to target osteosarcoma lung metastases — the most common site of spread — while minimizing systemic toxicity.
What to know before you search
Eligibility depends on disease stage (localized vs. metastatic), prior chemotherapy regimens, and specific molecular features for targeted therapy trials.
What types of trials are currently open
- Treatment trials — Testing new chemotherapy combinations, immunotherapy, and targeted drugs for metastatic or relapsed osteosarcoma.
- GD2-targeted trials — Evaluating antibodies, antibody-drug conjugates, and CAR-T therapies against the GD2 surface antigen.
- Surgical trials — Comparing limb-sparing versus amputation and evaluating new reconstruction techniques.
- Immunotherapy trials — Testing mifamurtide, checkpoint inhibitors, and combination immune approaches.
- Lung metastasis trials — Evaluating surgical resection strategies and aerosol chemotherapy for pulmonary metastases.
Recently added Osteosarcoma trials
Deep Phenotyping Gait Deficits in Orthopedic Manifestations of Pediatric Cancer Patients
The goal of DEEPGAIT study is to determine how serious walking problems are for pediatric cancer patients who have had orthopedic surgery, how they change over time, and what can be done to help. Healthy participants without cancer will also be included in this study in order to better understand the difference in walking problems between the 2 groups. DEEPGAIT is a long term study that uses advanced tools-including 3D motion capture, muscle sensors, force plates, and wearable devices-to take a detailed look at how these patients move. Their results are compared to healthy children of the same age and sex. PRIMARY OBJECTIVES * Characterize gait deficits in pediatric cancer patients 1 year following orthopedic surgery for lower limb bone sarcoma, soft tissue sarcoma, or steroid-induced avascular necrosis. * Identify personal, disease, treatment and environment risk factors for gait deficits in pediatric cancer patients 1 year following orthopedic surgery for lower limb bone sarcoma, soft tissue sarcoma, or steroid-induced avascular necrosis. SECONDARY OBJECTIVES * Build a library of broadly representative normative reference values to generate age- and sex-matched z-scores to quantify frequency, severity and progression of gait deficits among pediatric cancer patients in relation to healthy controls. * Characterize the changes of gait parameters in pediatric cancer patients with or without gait deficits 1 year after orthopedic surgery for lower limb bone sarcoma, soft tissue sarcoma, or steroid-induced avascular necrosis, up to 5 years after surgery. * Identify personal, disease, treatment and environment risk factors for trajectories of gait deficits in pediatric cancer patients with or without gait deficits 1 year after orthopedic surgery for lower limb bone sarcoma, soft tissue sarcoma, or steroid-induced avascular necrosis, up to 5 years after surgery.
Apatinib Combined With Liposomal Irinotecan for Refractory or Metastatic Osteosarcoma
In advanced osteosarcoma where traditional chemotherapy has failed, the multi-targeted tyrosine kinase inhibitor apatinib has become a mainstream systemic treatment option in China. However, for patients with a high tumor burden or extra-pulmonary lesions, these drugs are prone to secondary resistance, necessitating combination with chemotherapy for more effective comprehensive control. Liposomal irinotecan, a newly approved topoisomerase inhibitor, exhibits lower toxicity compared to traditional irinotecan and is one of the second-line chemotherapy agents for osteosarcoma, making it a suitable candidate for combination therapy with apatinib. The primary objective of this study is to determine the optimal regimen of apatinib combined with liposomal irinotecan injection, while the secondary objective is to evaluate the safety and efficacy of this combination in patients with refractory osteosarcoma who have progressed after second-line chemotherapy.
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