Optimizing Ewing Sarcoma and Osteosarcoma Biopsy Acquisition: Consensus Recommendations from the Children’s Oncology Group Bone Tumour Committee

Matthew Dietz, DO, MSEd joins us on OsteoBites to discuss Optimizing Ewing Sarcoma and Osteosarcoma Biopsy Acquisition: Consensus Recommendations from the Children’s Oncology Group Bone Tumour Committee.To advance the care and cure for patients with osteosarcoma and Ewing sarcoma it is necessary to safely improve the amount and usability of diagnostic biopsy material obtained. Indeed, it is anticipated that future osteosarcoma and Ewing sarcoma clinical trials will incorporate molecular biomarkers into treatment risk stratification underscoring the need for optimal tissue collection and processing practices.Historically open/incisional biopsies were the predominant biopsy approach; however, image-guided core needle biopsies have increased in frequency and are safe for patients. These procedures are less invasive and reduce recovery times but have potential limitations. Including the potential for lower tissue volumes, which can limit components of clinical care - including pathologic assessment, diagnostic accuracy, and molecular evaluations - along with the opportunity for research studies with leftover tissue (following informed consent). Additionally, once biopsy material is obtained the handling of the specimen for histologic and subsequent molecular testing requires careful timing, processing and tissue prioritization to ensure all clinical and research opportunities are preserved for the patient.To help optimize these critical elements in patient care the Children’s Oncology Group convened a multidisciplinary group of clinical and scientific experts to create reference recommendations for harmonizing tissue acquisition and processing algorithms for osteosarcoma and Ewing sarcoma specimens.