Journal of Orthopedic Oncology
Open Access

Orthopedic oncology; Immunotherapy; Immune system; Therapeutic

Introduction

Orthopedic oncology, the specialized field dedicated to the diagnosis and treatment of bone and soft tissue tumors, has witnessed significant advancements in recent years. Among these, the advent of immunotherapy has emerged as a game-changer in the realm of cancer treatment. Immunotherapy harnesses the power of the immune system to target and destroy cancer cells [1], offering a novel and promising approach that has revolutionized the field of oncology. Traditionally, orthopedic oncologists have employed a combination of surgery, radiation therapy, and chemotherapy to combat bone and soft tissue tumors. While these modalities have shown efficacy, they often come with substantial side effects and limited long-term benefits. Moreover, certain tumors, such as sarcomas, have proven to be particularly challenging to treat due to their aggressive nature and propensity for metastasis [2].

The introduction of immunotherapy has opened new avenues for the treatment of orthopedic malignancies. By leveraging the body’s immune response, immunotherapy aims to enhance the immune system’s ability to recognize and eliminate cancer cells with precision. This approach represents a paradigm shift in cancer treatment, offering the potential for improved outcomes, reduced toxicity, and increased survival rates for patients with orthopedic tumors [3].

Method

In this short communication, we delve into the role of immunotherapy in orthopedic oncology and explore its transformative impact on cancer care. We will discuss the principles behind immunotherapy, including its various modalities such as immune checkpoint inhibitors, adoptive cell therapies, and cancer vaccines. Furthermore, we will examine the specific applications of immunotherapy in the context of orthopedic malignancies, focusing on the treatment of bone and soft tissue sarcomas [4].

The emergence of immunotherapy has ignited a sense of optimism in the field of orthopedic oncology. It has the potential to address the limitations of conventional treatments, provide more targeted and effective therapeutic options, and improve the quality of life for patients. As we delve deeper into the role of immunotherapy in orthopedic oncology [5], it becomes evident that this approach holds immense promise in shaping the future of cancer treatment, paving the way for personalized and precise interventions that have the potential to transform the lives of patients facing these complex tumors.

Discussion

The advent of immunotherapy has brought about a paradigm shift in the field of orthopedic oncology, offering new hope and improved treatment outcomes for patients with bone and soft tissue tumors. Immunotherapy utilizes the body’s own immune system to specifically target cancer cells, providing a more precise and targeted approach compared to conventional treatments [6]. This section explores the specific applications and benefits of immunotherapy in orthopedic oncology, highlighting its transformative impact on cancer treatment.

1. Immune Checkpoint Inhibitors: One of the most significant breakthroughs in immunotherapy has been the development of immune checkpoint inhibitors (ICIs). These inhibitors target specific molecules on immune cells or cancer cells, allowing the immune system to recognize and attack cancer cells more effectively. In orthopedic oncology, ICIs have shown promising results in the treatment of various malignancies, including bone and soft tissue sarcomas. Clinical trials have demonstrated improved response rates and prolonged survival in patients receiving ICIs as a monotherapy or in combination with other treatment modalities.

2. Adoptive Cell Therapies: Adoptive cell therapies, such as chimeric antigen receptor (CAR) T-cell therapy, have emerged as powerful immunotherapeutic approaches in orthopedic oncology.

CAR T-cell therapy involves modifying a patient’s own immune cells to express a receptor that recognizes and targets specific tumor antigens. In the context of orthopedic tumors, CAR T-cell therapy has shown promising results in treating refractory or relapsed sarcomas, with some patients achieving complete and durable responses. Ongoing research aims to optimize this therapy and expand its application to a wider range of tumors [7-9].

3. Cancer Vaccines: Cancer vaccines represent another avenue of immunotherapy in orthopedic oncology. These vaccines stimulate the immune system to recognize and attack tumor cells by presenting specific tumor antigens. In the context of bone and soft tissue tumors, cancer vaccines have shown promise in stimulating immune responses and enhancing tumor regression. They have the potential to be used as adjuvant therapies following surgical resection, aiming to prevent tumor recurrence or metastasis.

4. Combination Therapies: The future of immunotherapy in orthopedic oncology lies in the exploration of combination therapies. Combining immunotherapy with traditional treatments, such as surgery, radiation therapy, and chemotherapy [10], holds the potential to enhance treatment efficacy and overcome resistance mechanisms. Synergistic effects have been observed when combining immune checkpoint inhibitors with radiation therapy or targeted therapies, leading to improved tumor control and survival rates. Furthermore, the integration of immunotherapy into multidisciplinary treatment approaches, involving surgeons, medical oncologists, radiation oncologists, and immunologists, is crucial for optimizing patient outcomes [11].

5. Challenges and Future Directions: While immunotherapy has shown remarkable success in certain orthopedic malignancies, challenges remain. Identifying predictive biomarkers that can accurately select patients who will benefit from immunotherapy is a priority for personalized treatment strategies. Additionally, managing immune-related adverse events and understanding mechanisms of resistance are areas of ongoing research [12].

Conclusion

In conclusion, the role of immunotherapy in orthopedic oncology represents a paradigm shift in cancer treatment. It offers the potential for more targeted and effective therapies with fewer side effects compared to traditional treatments. The application of immune checkpoint inhibitors, adoptive cell therapies, cancer vaccines, and combination approaches holds promise in improving treatment outcomes for patients with bone and soft tissue tumors. As ongoing research continues to refine immunotherapeutic strategies and unravel the complexities of the tumor-immune interaction, the integration of immunotherapy into the standard of care for orthopedic oncology patients is set to transform the field and provide new avenues of hope for those facing these challenging tumors.

1. Gold JS, Antonescu CR, Hajdu C (2002) Clinicopathologic correlates of solitary fibrous tumors. Cancer 94: 1057-1068.

Indexed at, Google Scholar, Crossref

2. Bjornsson J, Unni KK, Dahlin DC, Beabout JW, Sim FH (1984) Clear cell chondrosarcoma of bone. Observations in 47 cases. Am J Surg Pathol 8:223-230.

Indexed at, Google Scholar, Crossref

3. Cranshaw I, Gikas P, Fisher C (2009) Clinical outcomes of extra- thoracic solitary fibrous tumours. Eur J Surg Oncol 35: 994-998.

Indexed at, Google Scholar, Crossref

4. Demicco EG, Park MS, Araujo DM (2012) Solitary fibrous tumor: a clinic pathological study of 110 cases and proposed risk assess- ment model.

Indexed at, Google Scholar, Crossref

5. Kaim AH, Hugli R, Bonél HM, Jundt G (2002) Chondroblastoma and clear cell chondrosarcoma: radiological and MRI characteristics with histopathological correlation. Skeletal Radiol 31:88–95.

Indexed at, Google Scholar, Crossref

6. Little PJ, Drennon KD, Tannock LR (2008) Glucosamine inhibits the synthesis of glycosaminoglycan chains on vascular smooth muscle cell proteoglycans by depletion of ATP. Arch Physiol Biochem 114: 120-126.

Indexed at, Google Scholar, Crossref

7. Chiusaroli R, Piepoli T, Zanelli T, Ballanti P, Lanza M, et al. (2011) Rovati LC, Caselli G. Experimental pharmacology of glucosamine sulfate. Int J Rheumatol 2011: 939265.

Indexed at, Google Scholar, Crossref

8. Bjornsson J, Unni KK, Dahlin DC, Beabout JW, Sim FH (1984) Clear cell chondrosarcoma of bone. Observations in 47 cases. Am J Surg Pathol 8:223-230.

Indexed at, Google Scholar, Crossref

9. Choi H, Charnsangavej C, Faria SC (2007) Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol 25: 1753-1759.

Indexed at, Google Scholar, Crossref

10. Hangaard H, Gögenur M, Tvilling M, Gögenur I (2018) The effect of time from diagnosis to surgery on oncological outcomes in patients undergoing surgery for colon cancer: a systematic review. Eur J Surg Oncol44: 1479-1485.

Indexed at, Google Scholar, Crossref

11. Poggio F, Bruzzone M, Ceppi M, Ponde N F, Valle G et al. (2018) Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis. Ann Oncol 29: 1497-1508.

Indexed at, Google Scholar, Crossref

12. Nathalie L, Sun J, Gondara L, Diocee R , Speers C et al. (2020) Impact of pathologic complete response on survival after neoadjuvant chemotherapy in early-stage breast cancer: a population-based analysis. J Canc Res Clin Oncol 146: 529-536.

Indexed at, Google Scholar, Crossref