Stories about: osteosarcoma

ctDNA: Bringing ‘liquid biopsies’ to pediatric solid tumors

Brian Crompton studies the use of ctDNA as an alternative way to biopsy pediatric solid tumors
Brian Crompton with Stephanie Meyer (left) and Kellsey Wuerthele (PHOTO: JOHN DEPUTY)

Our blood carries tiny amounts of DNA from broken-up cells. If we have cancer, some of that DNA comes from tumor cells. Studies performed with adult cancers have shown that this circulating tumor DNA (ctDNA) may offer crucial clues about tumor genetic mutations and how tumors respond to treatment.

Brian Crompton, MD, with colleagues at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and elsewhere, is now working to bring ctDNA “liquid biopsies” to pediatric solid tumors as well. The researchers hope that these blood tests will eventually improve early detection, choice of treatment and monitoring of young patients with these diseases without having to sample the tumor itself.

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Mining similarities in pediatric and canine bone cancer to help both children and pets

dogs aid fight against osteosarcoma

In March 2016, Ollie, a therapy dog at Boston Children’s Hospital, paid a bedside visit to 7-year-old Carter Mock. The pug and the boy had something in common: Both had lost limbs to the bone cancer osteosarcoma. Ollie’s left front leg had been amputated at the shoulder, while Carter had just had a new knee fashioned from his ankle in a procedure called rotationplasty.

Biologically, the osteosarcoma that dogs develop is remarkably similar to osteosarcoma in children and youths. The tumors develop primarily in the long bones, and the spread of tumor cells to the lungs represents the most significant threat and challenge. Similar chemotherapy agents are used in both dogs and human patients to kill residual cancer cells. Researchers are now mining these similarities in a quest for new treatments to benefit pets and people alike.

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Is one look better than two? Assessing bone tumor removal during surgery

Wordle graphic of words associated with bone tumor surgery and intraoperative assessment.
One assessment of tumor margins during bone tumor removal surgery may suffice where two are done now.
Improvements in imaging technologies have made the process of defining the extent of bone tumors like osteosarcomas increasingly accurate.

But while it’s easier than ever to say, “The tumor starts here and ends here,” when removing a bone tumor surgically, surgeons still need to take a moment during the operation to check the edges (or “margins”) of the removed and remaining bone for any signs of remaining tumor, a step called intraoperative assessment.

“You need to make sure the tumor has been completely removed and a safe amount of normal tissue remains as a buffer,” says Sara Vargas, MD, director of patient safety and quality in Boston Children’s Hospital’s Department of Pathology. “Achieving a margin that is free of tumor reduces a patient’s long-term risk of local tumor recurrence.”

During surgery, there are two ways to do the assessment, each method providing a check on the other: gross split specimen inspection and frozen section inspection.

The two methods, which are often done either simultaneously or in tandem during surgery, are quite different.

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