Osteosarcoma is a primary malignant bone disease that is most common in adolescents and young adults. It peaks in late adulthood. During chemotherapy with a standard regimen of cisplatin / doxorubicin / methotrexate Combined with surgical resection (known as MAP), the prognosis of patients with localized tumors is significantly improved, with up to 40-50% of patients relapsed and eventually succumb to the disease and patients with metastatic disease. The prognosis is even worse. There have been no advances in new therapies in the last 30 years, and the progression of this disease is hampered by the lack of well-validated biomarkers that may promote patient stratification to new therapies. Pathological necrosis in response to neoadjuvant chemotherapy is prognostic but does not fully correlate with the outcome of a subset of patients with suboptimal responses. In addition, it is semi-quantitative and can only be evaluated by an experienced pathologist after several cycles of chemotherapy have been administered. Recent large-scale international randomized studies using pathological necrosis to stratify patients to add ifosfamide / etoposide or interferon to adjuvant therapy are currently available with the need for new therapies. The benefits of survival could not be demonstrated, reflecting both prognostic / stratified marker limitations. This leads to increased interest in molecular outcome markers. In this regard, miRNAs have recently received attention due to their recognized regulatory role in many downstream genes in cancer. Our group previously published pilot results suggesting that microRNAs are useful for stratifying the prognosis of osteosarcoma.

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