Background
Osteosarcoma is as a very aggressive primary bone tumor, affecting mainly young populations. Most cases diagnosed have distant macro and micro-metastases at the time of diagnosis. Surgical resection with neoadjuvant and adjuvant therapies improve overall and disease-free survival of patients. Doxycycline, a synthetic tetracycline has been found to act either as an antibiotic drug as well as a chemotherapeutic agent. Its anti-neoplastic role has been proven to be extremely significant in various types of cancer like prostate, intestinal, central neural system cancers and osteosarcoma. Inhibition of metalloproteinases (MMPs) in different stages of tumor expansion is the most well understood mechanism. MMPs are secreted molecules from various normal cells like fibroblasts, leucocytes and vascular smooth muscles but also from cells with high proliferative potential like tumor cells. In osteosarcoma, MMPs have been found to be overexpressed. MMPs help osteosarcoma cells to survive, grow and give metastases in distant sites, mainly in lungs. Doxycycline, blocks extracellular matrix and basic membranes degradation by suppressing MMPs function. As a consequence, osteosarcoma cells lose their ability to invade and give metastases. Additionally, doxycycline eliminates the secretion of vascular endothelial growth factor (VEGF) and deprives the supply of circulating nutritious components, by its anti-angiogenesis action. The aim of this review is to evaluate doxycycline’s action against osteosarcoma cells as an MMP-inhibitor and interpret its usage as a chemotherapeutic agent.
Methods
We checked PubMed and Google Scholar for recent published data, on the tumor-supportive role of MMPs and VEGF in osteosarcoma cells. We further studied published experimental trials, on the role of doxycycline as a tumor-suppressive agent via MMPs and VEGF inhibition.
Results
MMPs and VEGF have been found to play a fundamental role in osteosarcoma cells survival and its high aggressiveness by in vitro, in vivo and clinical trials. Nevertheless, Doxycycline proved its tumor-suppressive effect, by in vivo experimental trials in various cancers, but not yet in osteosarcoma.
Conclusion
Doxycycline remains a promising chemotherapeutic agent against osteosarcoma, via MMPs inhibition, showing of the need, for further in vivo and clinical trials to carried out in the future.
Key Words: Osteosarcoma, Metalloproteinase, VEGF, Doxycycline, Metastasis