Abstract
Osteosarcoma is the most common bone tumor affecting both adolescents and children. Although localized osteosarcoma has an overall survival of >70% in the clinic, metastatic, refractory, and recurrent osteosarcoma have poorer survival rates. Exosomes are extracellular vesicles released by cells and originally thought to be a way for cells to discard unwanted products. Currently, exosomes have been reported to be involved in intercellular cross-talk and induce changes in cellular behavior by transferring cargoes (proteins, DNA, RNA, and lipids) between cells. Exosomes regulate osteosarcoma progression, and processes such as tumorigenesis, proliferation, metastasis, angiogenesis, immune evasion, and drug resistance. Increasing evidences shows that exosomes have significant potential in promoting osteosarcoma progression and development. In this review, we describe the current research status of exosomes in osteosarcoma, focusing on the biological functions of osteosarcoma exosomes as well as their application in osteosarcoma as diagnostic biomarkers and therapeutic targets.
Highlights
Bone malignancies are the third leading cause of cancer-related deaths in children and adolescents (Jemal et al, 2007)
Exosomes could be secreted by different types of cells including osteosarcoma, bone mesenchymal stromal cells (BMSCs), cancer-associated stromal fibroblasts (CAFs), adipose tissue derived mesenchymal stromal cells (ADSCs), macrophages, and the secreted exosomes may contain a series of cargoes such as Micro RNAs (miRNAs), Long noncoding RNAs (lncRNAs), circRNAs, and proteins
The exosomes and exosomal cargoes derived from these cells could exert biological activity and modify the functional activity of recipient cells, including proliferation, invasion, migration, angiogenesis, apoptosis, metastasis and chemoresistance
Summary
Bone malignancies are the third leading cause of cancer-related deaths in children and adolescents (Jemal et al, 2007). Osteosarcoma is the primary bone malignancy that mainly affects this age group, accounting for about 60% of bone malignancies (Geller and Gorlick, 2010). In this article, we mainly discuss the osteosarcoma with poor survival. The most common complication of osteosarcoma is the development of metastatic diseases (Marina et al, 2004). Lung metastases are the leading cause of death in over 30% of patients with osteosarcoma (Botter et al, 2014). The overall survival rate of metastatic osteosarcoma is 20% after 5 years and the prognosis is poor (Allison et al, 2012; Zhu et al, 2013; Friebele et al, 2015; Saraf et al, 2018). Chemotherapy is the primary treatment, and drug resistance is common; there is a need for new approaches to improve the efficacy of chemotherapeutic agents and minimize their toxic side effects
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