Treatment for progressing bone sarcomas can be challenging. This is especially true after patients have had drugs to treat cancer but the cancer is still progressing.
A potential combination therapy of immunotherapy and TKI inhibitor treatment could help improve results for people with progressing bone sarcomas. This includes osteosarcoma.
An approach which may work includes using pre-trial clinical biomarkers. Doctors can use these to select which patients this treatment may help best. A biomarker is a marker of a body process. Biomarkers can help identify or measure illness. An example is measuring red blood cell count to identify anaemia (low blood iron).
This trial looked at combining two treatments. These were an immunotherapy treatment and a TKI InhibitorA drug that blocks or reduces the function of a particular protein. treatment, called nivolumab and sunitinib.
What happened in the trial?
A combination of the two treatments was given to 38 adults (aged between 18-80 years). 17 of these patients had osteosarcoma. The other patients had different types of bone sarcomas.
Sunitinib tablets were given every day by a tablet. The starting dose was 37.5mg for 14 days, followed by 25mg daily.
Nivolumab was given via a drip in a vein (intravenously). This was given every two weeks. The dose was 3mg per kg the patient weight. This means each patient had a dose made for them. This helps the medicine be more effective.
Every 8 weeks doctors checked the tumours. This was by a CT or MRI scan.
Outcomes
1. Progression-Free survival rate (PFSR): how long the participant’s cancer stayed the same without growing or getting worse. This was done using a standard cancer measure. It is known as Response-Evaluation Criteria in Solid Tumours (RECIST).
2. Overall survival rate: how long the participants survived after the treatment.
What were the results of the treatment?
1. PFSR at six months post-treatment was 42%. This means the average number of participants whose cancer did not progress after treatment was 42%.
2. The average overall survival rate was 11.9 months post-treatment. 72% of participants survived at 6, 12 and 18 months post-treatment.
3. 17% of participants stopped treatment due to negative side effects of the treatment.
Overall, this study showed a good level of results in a challenging cancer to treat effectively. Further research is needed to understand how these treatments could improve overall survival in osteosarcoma patients.
References:
1. Palmerini E, Lopez Pousa A, Grignani G, Redondo A, Hindi N, Provenzano S, et al. Nivolumab and sunitinib in patients with advanced bone sarcomas: A multicenter, single‐ARM, phase 2 trial. CancerA disease where cells divide and grow uncontrollably and can spread to other areas of the body.. 2024 Nov 14;131(1). doi:10.1002/cncr.35628