Bone Tumor

More than 1,000 children and adolescents are diagnosed each year with osteosarcoma or Ewing sarcoma across the Children’s Oncology Group (COG) network. These are the most common bone cancers in children, adolescents, and young adults, with osteosarcoma occurring slightly more often than Ewing sarcoma.

Treatment is intensive and typically includes chemotherapy combined with surgery for osteosarcoma, and chemotherapy with surgery and/or radiation for Ewing sarcoma. These cancers are biologically distinct. Ewing sarcoma is typically driven by a specific genetic change, while high-grade osteosarcoma arises from more complex genetic alterations. These differences influence how each disease is studied and treated.

While outcomes have improved for some patients, progress has been more limited for others, highlighting the need for continued advances in treatment.

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COG’s Work in Bone Tumor

COG’s Bone Tumor Committee leads clinical trials and biological research across all stages of osteosarcoma and Ewing sarcoma. Results from trials in newly diagnosed patients over the past decade have helped establish the current international standard of care for both cancers.

Current research focuses on understanding why some patients respond to treatment while others do not, using biologic markers such as circulating tumor DNA and genetic changes. These insights are shaping new approaches, including tailoring therapy in Ewing sarcoma and evaluating targeted therapies in osteosarcoma.

The committee also collaborates with the Pediatric Early Phase-Clinical Trial Network (PEP-CTN) to study new therapies, with more than 10 oncology drugs evaluated in the past decade. Many of these trials are available at a patient’s treating hospital, helping reduce the burden of travel for families.

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Recent Publications

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For the first time, researchers studying the biology of this cancer will have access to a large set of tissue samples. This is a huge piece of the puzzle that’s been missing, without them it’s very hard to develop new treatments for the disease. The same is true for blood samples – many doors will be open by studying biomarkers in the blood and detect even smaller levels of disease.

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COG Member Institutions

COG’s 220+ member institutions study and treat children and adolescents with cancer across a global network. These sites support patients from diagnosis through treatment and beyond, connecting families to clinical trials and specialized care closer to home.

Use our interactive map to find a COG member institution near you.

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News from COG

As the world’s largest pediatric cancer research network, COG drives breakthroughs in treatment and improves outcomes for children with cancer. Explore the latest news and stories from across our global community.

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The future for children with bone tumors is shaped by today’s research.

Your support helps fuel discoveries that deepen understanding and move us closer to cures and more effective treatments.

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