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Multi-disciplinary Team for Sarcoma Patients

Program: A Team Approach for Treating Sarcoma in Children and Adults
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Dr. Conrad:

Well, it's taken 20 years, but I'm really pretty proud of the team. We have a great team at Children's and we have a great team at the University and SCCA. That team really involves an oncologist working with a surgeon, working with a pathologist and a radiation therapist and other surgical partners. It really involves being in clinic together and being in conference together at a weekly basis and really sort of hashing out some of these challenging issues. It's a humbling business. There are lots of outliers that are constantly giving us sort of challenges week by week, and it's really critical to have that chemistry and those communications to be able to really provide the kind of care people deserve for these problems.

Andrew Schorr:

You mentioned about outliers, and I alluded to earlier different types of sarcoma. So whether you're talking about adults or children tell us about the diversity, if you will, of sarcoma and the challenges that presents.

Dr. Conrad:

So sarcoma is a malignancy of connective tissues. We like to say the tissues that hold you together, bone and muscle and tendon and nerves and arteries. And in kids it's mostly a tumor most of the tumors are benign tumors. They are in the skeleton, and then there's osteosarcoma and Ewing's sarcoma, which is the most common bony sarcomas, and they get a smaller number of soft tissue sarcomas. In adults, people in their 20s, 30s, 40s, 50s and 60s, they mostly get soft tissue sarcomas with a smaller number of bone cancers that actually start in bone. So we focus on soft tissue sarcomas in adults with a small number of bone tumors, and a larger number of bone cancers in children with a smaller number of soft tissue tumors.

If you take the subtypes for bone cancers there's only a few subtypes, osteosarcoma and Ewing's. If you take the subtypes in soft tissue sarcomas, there's 10 or 20 subtypes, at least 10 common subtypes, and each of those subtypes behave a little differently than the next and respond to a different drug. So in the adult world one of the challenges we have is in finding a particular drug that's going to be effective for high grade tumor and control that tumor and keep it from metastasizing vis a vis the subtype, the molecular subtype of the tumor. We spent many years defining those subtypes under the microscope, and now we're trying to do it with a DNA fingerprint and with imaging, and finding drugs that are going to really be effective for the different subtypes is going to be the second half of the game.

 

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