Managing the immune microenvironment of osteosarcoma: the outlook for osteosarcoma treatment

Abstract

Osteosarcoma, with poor survival after metastasis, is considered the most common primary bone cancer in adolescents. Notwithstanding the efforts of researchers, its five-year survival rate has only shown limited improvement, suggesting that existing therapeutic strategies are insufficient to meet clinical needs. Notably, immunotherapy has shown certain advantages over traditional tumor treatments in inhibiting metastasis. Therefore, managing the immune microenvironment in osteosarcoma can provide novel and valuable insight into the multifaceted mechanisms underlying the heterogeneity and progression of the disease. Additionally, given the advances in nanomedicine, there exist many advanced nanoplatforms for enhanced osteosarcoma immunotherapy with satisfactory physiochemical characteristics. Here, we review the classification, characteristics, and functions of the key components of the immune microenvironment in osteosarcoma. This review also emphasizes the application, progress, and prospects of osteosarcoma immunotherapy and discusses several nanomedicine-based options to enhance the efficiency of osteosarcoma treatment. Furthermore, we examine the disadvantages of standard treatments and present future perspectives for osteosarcoma immunotherapy.

(E)‐SIS3 suppressed osteosarcoma progression via promoting cell apoptosis, arresting cell cycle, and regulating the tumor immune microenvironment

“…The survival status of osteosarcoma patients was still poor due to drug resistance, recurrence, or metastasis (Wang et al, 2023). It's reported that the 5-year survival rates in osteosarcoma remained at 60%−70% in recent 20 years (Tian et al, 2023). Until now, the target therapy and immunotherapy in osteosarcoma still lack response.…”

“…Osteosarcoma is the most malignant primary bone tumor, which mainly happens in adolescents (Tian et al, 2022; Tian et al, 2023). At present, the treatment of osteosarcoma patients is still mainly chemotherapy combined with surgery (Chang et al, 2023).…”

Alendronate Triggered Dual‐Cascade Targeting Prodrug Nanoparticles for Enhanced Tumor Penetration and STING Activation of Osteosarcoma

“…[9] However, due to the unique physiological environment of OS mentioned above, the efficiency of nano drug delivery systems in OS treatment remains limited. [10] Drug delivery in OS is a cascade process at both tissue and cellular level. Although bone-targeting drug delivery systems can improve the drug enrichment in tumor sites, [11] the drug internalization in cancer cells is still limited due to the dense stromal tissue of OS.…”

Large Scale Comparative Deconvolution Analysis of the Canine and Human Osteosarcoma Tumor Microenvironment Uncovers Conserved Clinically Relevant Subtypes

“…Hence there is a clinically unmet need for biomarkers that can stratify patients into meaningful subgroups and open avenues for precision oncology. With the absence of a clear druggable, driving molecular target in Osteosarcoma 2 , several groups have turned their attention towards the tumor microenvironment (TME) aiming to identify immune-related transcriptional signatures associated with favorable prognosis [3][4][5][6][7][8][9][10][11] . However, due to shortage of data, the prognostic value of most signatures has not been comprehensively evaluated in multiple external cohorts, especially in the context of clinically established prognostic features such as the stage of disease at diagnosis and percent tumor necrosis following neoadjuvant chemotherapy 12 .…”