Bone Cancer

Published Date : Nov 2023
Category : Oncology
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A Review of the Various Types of Bone Cancer, Therapies, and Current Developments with DiseaseLandscape Insights

One of the diseases that poses a serious risk of death is bone cancer. There is a considerable tendency for many common malignancies, such as those of the breast, prostate, kidney, and lung, to metastasis to bones, particularly the ribs, hip, femur, and tibia.

According to NIH, about 5% of children have cancer and 0.2% of all cancers are primary bone cancers (PBC), which is still a rare disease. 1,720 PBC deaths are expected in 2020 in the United States, accounting for 0.3% of all cancer-related deaths. An assessed 3,600 new cases of primary bone cancer will be diagnosed. Adults with chondrosarcoma (40%) and osteosarcoma (28%), respectively, are most likely to get these two cancers. Osteosarcoma (56%) and Ewing sarcoma (34%) are the two most frequent sarcomas in children and adolescents. Less frequently occurring PBC forms include chordoma, undifferentiated pleomorphic sarcoma, adamantinoma, fibrosarcoma, and giant cell tumors of the bone. The global osteosarcoma male-to-female ratio is 1.43 to 1, indicating a prevalence of males in PBC.

A variety of malignancies that arise in the bones are referred to as bone cancers. Normal bone tissue is harmed by cancer cells that proliferate in bones. The type of bone cancer depends on the kind of cell and tissue that develops cancer.

Primary bone malignancies refer to cancers that originate inside the bone. Numerous cancers that originate in organs or other body parts often metastasize to the bones in addition to other body parts. These tumors are referred to as metastatic or secondary bone malignancies. Most frequently, lung, prostate, and breast cancers metastasis (spread) to the bones.

The tumor's location and size, as well as whether the disease has progressed to other regions, are factors in staging. There are four phases of primary bone cancer. In stage 1 the cancer cells are still confined, and the tumor is low-grade. Stage 2 is where the tumor is high-grade, but the cancer cells are still confined. In stage 3 disease has spread to other parts of the same bone and the tumor is high-grade. Stage 4 is when cancer has progressed from the bone to the liver or lungs, among other parts of the body.

Primary bone cancer is classified into four types:

Osteosarcoma: The most prevalent kind of bone cancer, osteosarcoma begins in the cells that produce new bone. Though it commonly starts at the extremities of big bones, such as the arms and legs, it originates in any bone. Osteosarcoma in children and teenagers is most frequently diagnosed by providers.

Ewing sarcoma: It is named after the physician who was the first to report this kind of bone cancer, Ewing sarcoma is a broad category that covers a variety of tumors with similar characteristics that are thought to start in the same cells. These tumors develop in the soft tissues and bones nearby. The hips, ribs, shoulder blades, and long bones like the legs are the most typical locations for Ewing sarcoma growth. Roughly 85% of Ewing sarcomas have the EWSR1/FLI1 fusion gene.

Chondrosarcoma: Cartilage is the first tissue in which chondrosarcoma develops. The soft connective tissue known as cartilage facilitates mobility between bones and joints. The body converts some cartilage to bone by adding calcium to it. The arm, leg, or pelvic bones are where this cancer usually first appears. In contrast to osteosarcoma and Ewing sarcoma, chondrosarcoma affects adults more often than children.

Chordoma: Usually near the base of the skull or the base of the spine, this uncommon tumor starts in the bones of the spine. Like chondrosarcoma, chordoma primarily affects elderly persons. This kind of bone cancer affects men more often than women.

Diagnostic Analysis

Imaging Tests

  • X-ray: A minimal dose of radiation is used in an x-ray to get an image of the internal body components. Where there is a lump or swelling, the doctor takes an x-ray of the affected area. On an x-ray, osteosarcoma typically exhibits a few common characteristics. Its appearance on an x-ray raises the possibility that there is an osteosarcoma.
  • Computed tomography (CT or CAT) scan: A CT scan uses x-rays captured from various angles to create images of the inside of the body. These images are combined by a computer to create a comprehensive, three-dimensional image that displays any anomalies or tumors. The size of the tumor is determined with a CT scan. In certain cases, a contrast medium—a unique dye—is administered prior to scanning to improve image detail. This dye is administered as a pill or liquid to consume, or it is injected into the vein. CT scans are commonly utilized to get pictures of the lungs as a possible site of tumor metastasis in cases with osteosarcoma.
  • Magnetic Resonance Imaging (MRI): Instead of using x-rays to create detailed images of the body, an MRI uses magnetic fields. The tumor's size is determined with MRI. To provide a crisper image, a unique dye known as a contrast medium is administered before the scan. A person gets this dye intravenously, orally, or as a liquid or pill to ingest. Different physical characteristics of the tumor are used to construct a picture by an MRI than by a CT scan. Some clinicians utilize magnetic resonance imaging (MRI) to learn more about the location of the tumor.
  • Positron Emission Tomography (PET) or PET-CT scan: A PET-CT scan is often a combination of a PET and a CT scan. However, our physician simply refers to this process as a PET scan. Using a PET scan, images of the body's tissues and organs are produced. A tiny dose of radioactive sugar is administered via injection to the patient. The cells that require the greatest energy absorb this sugar. Cancer tends to absorb more radioactive material since it is an energy-hungry disease. Nonetheless, the material has too little radiation to be dangerous. After that, a scanner finds this material to create photos of the interior of the body. When diagnosing osteosarcoma, a PET scan is performed to discover tumors that is far from the site of origin.
  • Bone Scan: During a bone scan, the interior of the bones is visualized using a radioactive tracer. The tracer doesn't contain nearly enough radiation to be dangerous. Injected into the patient's vein is the tracer. A specialized camera detects it when it accumulates in certain regions of the bone. Areas of injury, such as those brought on by cancer, stand out in the image, whereas healthy bone appears lighter to the camera. One method to determine whether osteosarcoma has spread to additional bones besides the original site is to perform a bone scan.

Tissue Sampling

  • Biopsy: A biopsy involves taking a little sample of tissue to examine under a microscope. Only a biopsy definitively diagnoses a tumor, even when other tests indicate that one is present. The sample(s) is next examined by a pathologist. A pathologist is a medical professional who focuses on diagnosing illness by analyzing cells, tissues, and organs and interpreting laboratory results. Testing genetic alterations in the tumor is another use for biopsy material. Talk about this with your child's physician because different websites lead them to suggest different genetic tests. A portion of these investigations are carried out in conjunction with clinical trial participation.
  • Blood Test: Blood tests are used to determine a person's overall health and look for tumor markers, which are substances produced by cancer cells such as alkaline phosphate.

Below is the list of market Players and diagnosis products in the Diagnostics industry -

                                                                     Diagnostic Market Players

Imaging Test

Tissue Sampling

Canon Medical Systems Corporation

Becton, Dickinson, and Company (BD)

Hitachi, Ltd.

Foundation Medicine, Inc.

Toshiba Corporation

Danaher Corporation

Siemens Healthineers

Genomic Health, Inc.

Philips Healthcare

Biocept, Inc.

Shimadzu Corporation

Guardant Health, Inc.

Thermo Fisher Scientific

Biodesix, Inc

Bristol-Myers Squibb Company

Hologic, Inc.

Esaote S.p.A.

Roche Diagnostics

Neusoft Medical Systems Co., Ltd.

Abbott Laboratories

Mindray Medical International Limited


Genomic Health, Inc.


Agilent Technologies, Inc.


General Electric Company (GE Healthcare)



                                                                   Diagnosis Products

Imaging Tests

Tissue Sampling

SIGNA™ Architect


Optima™ CT






Discovery™ CT




SIGNA™ Pioneer


Revolution™ CT


Discovery™ PET/CT




VUE Point™ FX


Discovery™ MI

BD SurePath™


BD Vacutainer®


BD Vacutainer®




Treatment Analysis

Radiation therapy, chemotherapy, surgery, and other progressive therapies are available for the treatment of primary bone cancer. They are used alone or in combination. The recommended course of treatment is contingent upon the nature, extent, and position of the tumor in addition to age and overall health.


Surgery is the process of operating to remove a tumor along with some surrounding tissue. A physician who specializes in bone cancer surgery is known as an orthopedic oncologist.

During limb-sparing surgery, medical professionals employ several procedures to preserve the child's use of the tumor-affected arm or leg while also restoring the limb's normal appearance. Reconstructive surgery and bone grafting are surgical methods. A bone allograft replaces and repairs damaged bone by using bone from another person. Metal allografts are used in most reconstructions. Children and teenagers with osteosarcoma are most frequently treated with limb-sparing surgery. Occasionally, the procedure that yields the strongest and most functional limb is not always the same as the one that yields the most normal appearance. A bone marrow transplant (BMT) involves taking out a patient's bone marrow and either transferring the blood-forming cells to another person or returning the bone marrow to the original patient later.


Chemotherapy involves using medications to kill cancer cells, usually by preventing the cells from proliferating, dividing, or developing into new ones. Chemotherapy, often known as systemic therapy, is administered into the bloodstream to target cancer cells throughout the body. It is often administered orally (as a tablet) or by an intravenous (IV) tube inserted into a vein with a needle. Systemic chemotherapy is most often administered to adolescents and teenagers with high-grade osteosarcoma. Without systemic chemotherapy, the survival rate for patients with localized, high-grade osteosarcoma is less than 20%, however, it reaches 50% to 75% with chemotherapy.

Radiation Therapy

High-energy X-rays or other particles are used in radiation treatment to kill cancer cells. A radiation oncologist is a medical professional who specializes in administering radiation treatment to treat cancer. External-beam radiation therapy is typically utilized as a radiation treatment for osteosarcoma. This is radiation therapy administered externally, via a machine. A radiation therapy programmed, or regimen, often entails a predetermined number of treatments administered over a predetermined length of time.

It is rare to use radiation therapy for osteosarcoma. This is due to radiation therapy's relative ineffectiveness against osteosarcoma. Most patients whose osteosarcoma cannot be surgically excised or if some of the tumor persists after surgery are candidates for radiation therapy.

Some common type of radiation therapies includes –

  • Intensity-Modulated Radiation Therapy
  • Proton Therapy
  • Stereotactic Radiosurgery
  • Brachytherapy

Drug Therapy

Kinase inhibitors are prescription drugs used in the treatment of certain types of bone cancer. Proteins in the cell (or on its surface) called kinases are generally responsible for relaying signals, instructing the cell to proliferate. In some cases, blocking specific kinases helps stop or reduce the growth of cancers.

The most common uses for these medications are in the treatment of chordomas that have spread or returned following therapy. Advanced Chondrosarcomas: These medications are also used to treat them.

                                                                      Treatment Market Players

Radiation Therapy


Drug Therapy

Varian Medical Systems

Siemens Healthineers

Pfizer Inc.


Thermo Fisher Scientific Inc.

Amgen Inc.


GE Healthcare

Novartis AG

Siemens Healthineers

Halyard Health, Inc.

Eli Lilly and Company


Mevion Medical Systems

Merck & Co

Mitsubishi Electric Corporation

Becton, Dickinson, and Company

Bayer AG

Hitachi, Ltd.

Stryker Corporation

Bristol-Myers Squibb Company,

Brainlab AG

Varian Medical Systems

Takeda Pharmaceutical

Best Theratronics Ltd


F. Hoffmann-La Roche Ltd



AstraZeneca PLC



Gilead Sciences, Inc.



                                                                       Treatment Products

Radiation Therapy


Drug Therapy


BD Plastipak™ Syringe pump



Alaris™ Pump module



SIGMA Spectrum® Infusion System



Alaris™ Syringe module



BD Alaris™ gravity set



Alaris™ PC unit



BD Alaris™ Pump module set



BD Alaris™ Syringe module set



BD Nexiva™



BD Angiocath™



BD Insyte™



BD Introsyte™



BD Introsyte™


MRIdian Cobalt

BD CareFusion™ Syringe pump


Siemens Primus Linear Accelerator

ARROW® Catheters



Key Developments

  • The pharmaceutical company Johnson & Johnson Private Limited announced on August 10, 2023, that the FDA had granted accelerated approval for TALVEY (talquetamab-tgvs), a first-in-class bispecific antibody, for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy, including an immunomodulatory agent, an anti-CD38 antibody, and a proteasome inhibitor.
  • To create cutting-edge cancer treatments, Pfizer Inc., a pharmaceutical firm, said in November 2021 that it would acquire clinical-stage oncology startup Trillium Therapeutics Inc.
  • A multinational conglomerate with headquarters in Japan, FUJIFILM Holdings Corporation, announced in January 2021 that it would begin offering medical screening services in India and other developing nations in the Middle East, Africa, and Southeast Asia for the detection of different cancer types, including bone, lung, breast, and cervical cancer.
  • The multinational pharmaceutical corporation Johnson & Johnson Private Limited declared in October 2020 that it had completed the acquisition of Momenta Pharmaceuticals, Inc. to offer additional potential for treating a range of illnesses, including neuroscience, oncology, pulmonary hypertension, infectious diseases, and vaccines.

Clinical Trail Assessment

DiseaseLandscape Insights (DLI) consultancy firm provides valuable support in future market trends on the development of new pharmaceutical products. This support helps to streamline the planning and execution of clinical trials of novel medications and treatments, implement effective patient recruitment strategies, ensure regulatory compliance, and increase the likelihood of successful trial outcomes.

The below table gives information about some currently ongoing clinical trials, including their study titles and respective stages:

Phase 1

Phase 2

Phase 3

Phase 4

Losartan + Sunitinib in Treatment of Osteosarcoma

Pulmonary Resectable Osteosarcoma Treated by Metastasectomy and Pre-operative Immunotherapy and Stereotactic Body Radiotherapy (PROMIS): a Prospective Clinical Trial

Chemo-radiotherapy Versus Radiotherapy in the Treatment of Salivary Glands and Nasal Tumors (IMRT or Protontherapy)

Study of XGEVA® (Denosumab) in Chinese Adults and Skeletally Mature Adolescents with Giant Cell Tumor of the Bone

Phase Ib / Regorafenib with Conventional Chemotherapy/Newly Diagnosed Patients/ Multimetastatic Ewing Sarcoma

Mifamurtide Combined with Post-operative Chemotherapy for Newly Diagnosed High Risk Osteosarcoma Patients

Perioperative Use of Tranexamic (TXA) in Bone Tumor Surgery Will Change in Blood Loss and Transfusion Requirements.

Clinical Trial of Lithium Carbonate Combined with Neo-adjuvant Chemotherapy to Treat Osteosarcoma

A Dose Finding Study to Treat Bone Tumor(s)

Zoledronic Acid-loaded Bone Cement as a Local Adjuvant Therapy for Giant Cell Bone Tumor After Intralesional Curettage

Tranexamic Acid Use to Reduce Blood Transfusion in Pediatric Cancer Patients Undergoing Limb Salvage Procedure

Serial Magnetic Resonance Imaging for the Prediction of Radiation-Induced Changes in Normal Tissue of Patients with Oral Cavity or Skull Base Tumors

A Study of ZN-c3 in Combination with Gemcitabine in Subjects with Osteosarcoma

Humanized Monoclonal Antibody 3F8 (Hu3F8) With Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) in the Treatment of Recurrent Osteosarcoma

Neoadjuvant Combination of Doxorubicin, Cisplatin and Methotrexate in Patients Aged 24-40 Years with Primary Bone Tumors

Comparing Continuation or De-escalation of Bone Modifying Agents (BMA) in Patients Treated for Over 2 Years for Bone Metastases from Either Breast or Castration-resistant Prostate Cancer

A Phase I Feasibility and Safety Study of Fluorescein-Specific (FITC-E2) CAR T Cells in Combination With Parenterally Administered Folate-Fluorescein (UB-TT170) For Osteogenic Sarcoma

Atezolizumab and Cabozantinib for the Treatment of Adolescents and Young Adults with Recurrent or Metastatic Osteosarcoma, TACOS Study

Prevention of Symptomatic Skeletal Events with Denosumab Administered Every 4 Weeks Versus Every 12 Weeks

Investigation of Radium-223 Dichloride (Xofigo), a Treatment That Gives Off Radiation That Helps Kill Cancer Cells, compared to a Treatment That Inactivates Hormones (New Antihormonal Therapy, NAH) in Patients with Prostate Cancer That Has Spread to the Bone Getting Worse on or After Earlier NAH

Gemcitabine, Docetaxel, and Hydroxychloroquine in Treating Participants with Recurrent or Refractory Osteosarcoma

Apatinib With Ifosfamide Plus Etoposide for Relapsed or Refractory Osteosarcoma (OAIE)

Thoracotomy Versus Thoracoscopic Management of Pulmonary Metastases in Patients with Osteosarcoma


Natalizumab in Recurrent, Refractory, or Progressive Pulmonary Metastatic Osteosarcoma


18F-Sodium Fluoride (NaF) PET to Replace Bone Scintigraphy: Safety and Efficacy Assessment




DiseaseLandscape Insights (DLI) assists manufacturers in developing and implementing viable remedies to interrupt and manage Crohn’s Disease outbreaks. Furthermore, there is an increasing need for diagnostic tools, clinical evaluations, and innovative therapies because of greater awareness and estimated epidemics.

DiseaseLandscape Insights offers essential knowledge and expertise to major stakeholders involved in the manufacture of therapeutic goods. DiseaseLandscape Insights' support makes it easier for market participants to organize and carry out clinical trials for innovative medicines and pharmaceuticals, patient recruiting tactics, and regulatory compliance.

Ultimately, this encourages the leaders to perform qualitative research, explore the manufacturing organizations, and learn about raw material suppliers. DLI services assist all industry players to stay one step ahead and obtain a stronger foothold in the Bone Cancer.

Vishal SawantBusiness Development

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