Standard of care treatment for primary bone cancer patients involves surgery to remove the entire cancer and a significant region of tissue from around the tumour. After surgery, patients need additional treatment to repair the area where the bone was removed, ensure it is functional and to prevent the cancer coming back (recurrence).
Depending on the size of the area of bone that is removed, different surgeries are necessary to repair the lost bone. Small bone areas, often the case in chordoma, can be repaired using man-made bone materials, known as ‘synthetic biomaterials’ or with bone harvested from the patient. For larger tumours, as is normally the case in osteosarcoma, orthopaedic implants are required.
Regardless of the method chosen to replace the bone that is removed, neither help prevent recurrence.
Chemotherapy is often used in osteosarcoma after surgery, to destroy any cancer cells which may remain in the area, but of course, chemotherapeutics cause severe toxicity and are ineffective in chordoma.
What are the aims of this research project?
Professor Richard Martin, at the University of Aston, in collaboration with Professor Lee Jeys at the Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, aim to develop new materials that can promote bone regeneration, whilst simultaneously preventing local reoccurrence of cancer at the surgical site.
Gallium-nitrate is an inorganic material that is effective in destroying cancer cells. Unlike chemotherapy, it does not deplete white blood cells and platelets and it has been shown to enhance the re-generation of bone. The downside of this treatment is that it must be given by a continuous intravenous infusion for 5-7 days, which is highly restrictive for patients.
The team of researchers behind this project are developing gallium containing synthetic biomaterials that can be placed directly in the area where the tumour was after surgery, or can be used to coat orthopaedic implants, thus slowly releasing the gallium ions that can kill any remaining cancer cells, help with bone repair after surgery and ultimately prevent recurrence.
How could this project improve treatment options for chordoma and osteosarcoma patients?
Successful completion of this project will provide sufficient data to confirm the potential of this technology.
It is expected that these materials will significantly reduce healing time and reduce local cancer reoccurrence. These materials have the potential to reduce the need for additional chemotherapy and improve outcomes for patients.