Over the past several decades, outcomes for patients with osteosarcoma have remained largely unchanged due to a major lack of treatment advancements.
A pioneering, collaborative trial, ICONIC, sought to address this limited progress by taking significant steps to improve our understanding of the biology and treatment of osteosarcoma. Funded by the Bone Cancer Research Trust, ICONIC set out to recruit every newly diagnosed osteosarcoma patient, gathering an unprecedented amount of information and samples to inform much-needed research and, ultimately, lead to better treatments, greater survival and improved quality of life for patients.
ICONIC: Improving outcomes through Collaboration in Osteosarcoma
Since opening in 2018, ICONIC has built up support throughout the osteosarcoma community. Through strong collaboration between researchers, oncologists and pathologists from across the UK, over 240 patients have so far been recruited from 29 collaborating hospitals, including all five of the UK’s specialist bone cancer surgical centres. This has resulted in a comprehensive clinical database of patients and a large collection of valuable blood and tumour tissue samples, as well as vital information relating to care pathways and the impact of treatment. Collectively, these have the potential to drive forwards future in-depth osteosarcoma research, allowing researchers to identify and address important questions and achieve meaningful outcomes for patients.
In order to take these next crucial steps, further funding is needed.
The £1,000,000 Ad-ICONIC programme of research will seek to accelerate much needed advancements by extending ICONIC recruitment, expanding the available data and samples, and performing a breadth of in-depth analyses.
What are the aims of this research project?
By building on ICONIC’s significant progress and established infrastructure, Ad-ICONIC ultimately aims to improve survival and quality of life for patients living with osteosarcoma, using the samples and data collected to address priority areas of unmet need.
The project will be split into several different ‘packages’ of work, each looking to address a different research need, as prioritised by the osteosarcoma community.
Work package 1: furthering recruitment
Ad-ICONIC aims to recruit additional patients to reach a target of around 400. Participants will be followed up over a longer period of time in order to strengthen and extend the data and the blood & tissue samples available to researchers. An additional type of blood sample will also be collected from some patients, supporting the aims of work package 3. This will provide peripheral blood mononuclear cells, critical cells of the immune system which will be key to research seeking new osteosarcoma specific drug targets.
MRI and CT images, taken during patients’ routine clinical care, will also be collected, to explore whether these can further our understanding of the diagnosis and management of osteosarcoma.
Work package 2: developing a clinical trial
Robust clinical trials determine the most effective treatments and are the essential stepping-stone towards treatment advancements for patients. However, clinical trials in osteosarcoma are lacking. Researchers will review data from recent clinical trials to pinpoint the best available treatment for osteosarcoma and, crucially, look to develop a clinical trial which could take forwards new therapies.
Work package 3: characterising patients’ tumours to develop targeted treatments
Building on ongoing laboratory research, researchers will use the extensive collection of samples to seek out new targets for treatment. These efforts will be supported by data already acquired through whole genome sequencing (WGS), a method which allows researchers to explore the entire set of genetic instructions (DNA) found in each cell.
By identifying targets which harness patients’ own immune system, they hope to take steps towards developing more effective treatments which can be delivered directly to osteosarcoma cancer cells, reducing side-effects and improving outcomes for patients.
Work package 4: understanding & improving patients’ quality of life
Quality of life of patients with osteosarcoma is also a central focus of Ad-ICONIC. Researchers will look to objectively improve this by understanding the impact of treatment and other factors which affect patients’ quality of life, finding ways of identifying those who may not respond to treatment (and could therefore potentially avoid debilitating side-effects) and, crucially, looking to achieve earlier diagnosis.
How could this project improve treatment options for osteosarcoma patients?
The osteosarcoma community have continued to endure gruelling treatments, limited research and unchanging outcomes for many years.
Ad-ICONIC will drive forward research to develop new, more effective and more targeted treatments, as well as mapping out ways to better support patients’ quality of life throughout their treatment and beyond.
The potential impact of this ground-breaking research is further magnified by plans for the data and samples collected in this study to be shared with the wider osteosarcoma community, fostering collaboration in the UK and internationally.
Ultimately, the goal of this research is to improve the care and treatment of patients with osteosarcoma, leading to greater survival and better quality of life.