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Review
. 2023 Oct 19;15(20):5044.
doi: 10.3390/cancers15205044.

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

Caleb Kim  1 , Lara E Davis  2 , Catherine M Albert  3 , Brian Samuels  4 , Jesse L Roberts  5 , Michael J Wagner  6   7
Affiliations
Review

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

Caleb Kim et al. Cancers (Basel). .

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.

Keywords: AYA; adolescent/young adult oncology; bone tumors; osteosarcoma; sarcoma.

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Conflict of interest statement

All COI are unrelated to the current work. M.J.W.—Clinical trial support from Deciphera, Adaptimmune, GSK, Athenex, Foghorn Therapeutics, Shaqsi, Presage Biosciences, Inhibrx, Incyte. Consulting fees from Adaptimmune, Epizyme, Aadi, Deciphera. L.E.D.—Research supported by Novartis, Eisai, BTG. Consulting fees from Aadi, Daiichi, Deciphera, Regeneron, Springworks. Clinical trial support from Ayala, BTG, BioAtla, Cornerstone, Eisai, Epizyme, Genentech, GSK, InhibRx, Oncternal, Salarius, Springworks. No disclosures: C.K., C.M.A., B.S., J.L.R.

Figures

Figure 1
Figure 1
Osteosarcoma cell alterations potentially contributing to age-related differences in outcomes. Genes/proteins in green are amplified or pathologically activated, genes/proteins in yellow are tumor suppressors, and pathogenic alteration is loss of function. Abbreviations: Cdk4, Cyclin Dependent Kinase 4; Rb1, RB Transcriptional Corepressor 1; p53, Tumor Protein P53; Mdm2, MDM2 Proto-Oncogene; CDKN/p1/Inka, Cyclin Dependent Kinase Inhibitor 2A; p14/ARF, ARF tumor suppressor; CDKN2b/p15/Inkb, Cyclin Dependent Kinase Inhibitor 2B; MAPK, Mitogen-Activated Protein Kinase pathway; Jun/Fos, Jun/Fos Proto-oncogene pathway; Wnt, Wnt/Beta-catenin pathway.
Figure 2
Figure 2
Differences and Similarities in Osteosarcoma by Age.
See this image and copyright information in PMC

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