Clinical trials of systemic therapy in osteosarcoma and Ewing’s sarcoma: past, present and future

Due to multiple factors, including their low incidence, heterogeneity and span of ages of affected patients, both osteosarcoma and Ewing’s sarcoma pose significant challenges to oncologists and patients. Despite these obstacles, significant progress has been made in the last 40 years in improving the survival of patients with localized osteosarcoma and Ewing’s sarcoma through multidisciplinary management. However, patients with primary refractory disease or disseminated disease fare poorly, emphasizing the need for novel therapies. Unfortunately, given their rarity, novel therapies for these tumors are difficult to rigorously trial. Current investigation is focused on identification of active targeted therapies in trials in patients with relapsed or refractory disease. Here we review the past, present and potential future clinical trials of systemic therapy in osteosarcoma and Ewing’s sarcoma.