Current Status and Prospects of Targeted Therapy for Osteosarcoma

Abstract

Osteosarcoma (OS) is a highly malignant tumor occurring in bone tissue with a high propensity to metastasize, and its underlying mechanisms remain largely elusive. The OS prognosis is poor, and improving the survival of OS patients remains a challenge. Current treatment methods such as surgical approaches, chemotherapeutic drugs, and immunotherapeutic drugs remain ineffective. As research progresses, targeted therapy is gradually becoming irreplaceable. In this review, several treatment modalities for osteosarcoma, such as surgery, chemotherapy, and immunotherapy, are briefly described, followed by a discussion of targeted therapy, the important targets, and new technologies for osteosarcoma treatment.

Keywords: chemotherapy; osteosarcoma; surgical treatment; targeted therapy.

Figure 1

MSTS system for OS surgical resection margins. An intra-lesional margin is formed when any point enters the tumor during OS resection. The red line represents the intra-lesional margin. Margins are formed when peeling during surgery stretches to or across the reaction zone surrounding the tumor. The blue line represents the marginal margin. Wide margins are created when there is no access to the reaction zone and the entire dissection passes through healthy tissue. The green line represents the wide margin.

Figure 2

Important targets for osteosarcoma therapy and their main functions. Various receptors capable of acting as targets in OS cells serve different purposes. PDGFR promotes the survival and migration of OS cells, IGF-1 receptor promotes their differentiation; these two receptors can work together to produce mTOR in the PI3K pathway to enable OS cells to proliferate and metastasize. In addition to its vasculogenic role, VEGFR activates MEK, which has the effect of promoting OS gene expression. In addition to its angiogenic effects, VEGFR activates MEK, which also makes a useful contribution in promoting OS gene expression. Targets that also have important roles in the cell cycle, such as WEE1 acting at the G2/M test site, AURKA/B acting in mitosis, and CDKs produced in the G1 phase, show facilitative effects on OS.