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Personalizing treatment for patients with osteosarcoma

Osteosarcoma is the cancer that Canadian hero Terry Fox was diagnosed with when he was just 18. The most common type of bone cancer in young adults, it is characterized by tumours that usually appear in the long bones around the knee or upper arm. However, because not all tumours are the same, there is no one-size-fits-all treatment.

Adjusting therapy for patients with osteosarcoma is one of the main clinical gaps that needs to be addressed to improve outcomes, says Dr. Joanna Przybyl, assistant professor at McGill University and principal investigator at The Research Institute - McGill University Health Centre.

“These tumours have different molecular profiles, which is something that needs to be recognized and incorporated into clinical care. Based on these molecular profiles, a different type of therapy may be more appropriate for selected patients,” she says.

With funding from a 2024 Terry Fox New Investigator Award, Dr. Przybyl will develop a novel liquid biopsy test to examine the molecular profiles of osteogenic tumours and predict potential treatment outcomes. In doing so, she hopes to help future patients by opening pathways to better treatment options and more personalized care.

“Liquid biopsy is an innovative technology that’s already transformed clinical care for patients because it allows us to analyze genetic changes in the tumour using a simple blood draw, rather than the invasive procedures usually required to access genetic material,” says Dr. Przybyl. “However, we still don't have the right markers to apply it to osteosarcoma.”

In this project, she will identify these essential biomarkers so that liquid biopsy can be used to guide and improve care for patients with osteosarcoma. This approach will not only improve outcomes by matching patients with a treatment their tumour will respond to, but also spare patients from the serious side-effects incurred through ineffective treatments.

Over the next three years, Dr. Przybyl will focus on three main goals.

  • First, she will create a liquid biopsy test to predict which patients could benefit from neo-adjuvant therapies. (These are treatments such as chemo- or radiotherapy that can be administered before primary care such as surgery to remove an osteogenic tumour.)
  • Next, she will use liquid biopsy to analyze the genetic material osteogenic tumours release into the blood to identify biomarkers and classify these tumours into molecular subtypes.
  • Finally, she will examine the nucleotide composition of DNA molecules present in blood to understand how these DNA molecules got there in the first place. This relatively unexplored area of research may provide additional insight into the biological processes underlying tumour development and contribute to predicting a tumour’s response to treatment.

“Long-term, this work will allow us to use liquid biopsy technology as a tool for precision medicine in osteosarcoma and adapt it to other types of sarcomas and cancer,” says Dr. Przybyl.