The Heterogeneity of Infiltrating Macrophages in Metastatic Osteosarcoma and Its Correlation with Immunotherapy

The Prognostic Model Established by the Differential Expression Genes Based on CD8+ T Cells to Evaluate the Prognosis and the Response to Immunotherapy in Osteosarcoma

Osteosarcoma (OS) is a malignant tumor with an extremely poor prognosis, especially in progressive patients. Immunotherapy based on immune checkpoint inhibitors (ICIs) is considered to be a promising treatment option for OS. Due to tumor heterogeneity, only a minority of patients benefit from immunotherapy. Therefore, it is urgent to explore a model that can accurately assess the response of OS to immunotherapy. In this study, we obtained the single-cell RNA sequencing datasets of OS patients from public databases and defined 34 cell clusters by dimensional reduction and clustering analysis. PTPRC was applied to identify immune cell clusters and nonimmune cell clusters. Next, we performed clustering analysis on the immune cell clusters and obtained 25 immune cell subclusters. Immune cells were labeled with CD8A and CD8B to obtain CD8⁺ T cell clusters. Meanwhile, we extracted the differentially expressed genes (DEGs) of CD8⁺ T cell clusters and other immune cell clusters. Furthermore, we constructed a prognostic model (CD8-DEG model) based on the obtained DEGs of CD8⁺ T cells, and verified the excellent predictive ability of this model for the prognosis of OS. Moreover, we further investigated the value of the CD8-DEG model. The results indicated that the risk score of the CD8-DEG model was an independent risk factor for OS patients. Finally, we revealed that the risk score of the CD8-DEG model correlates with the immune profile of OS and can be used to evaluate the response of OS to immunotherapy. In conclusion, our study revealed the critical role of CD8 cells in OS. The risk score model based on CD8-DEGs can provide guidance for prognosis and immunotherapy of OS.

Development of personalized classifier based on metastasis and the immune microenvironment to predict the prognosis of osteosarcoma patients

Background

Osteosarcoma is a common malignant bone tumor with a poor prognosis. The progression and metastasis of osteosarcoma are significantly influenced by the tumor microenvironment (TME). This study aimed to develop a personalized classifier based on metastasis and immune cells in the TME to achieve better prognostic prediction in osteosarcoma.

Methods

Firstly, osteosarcoma metastasis-related differentially expressed genes (DEGs) and infiltrating immune cells in the TME were analyzed using a series of bioinformatics methods. The metastasis-related gene signature (MRS) and TME score of osteosarcoma patients were then developed. On this basis, a personalized MRS-TME classifier was constructed and validated in other clinical cohorts and different subgroups. In addition, the relationship between the MRS-related genes and the immune microenvironment was also clarified. Finally, the signaling pathways and immune response genes in osteosarcoma patients among different MRS-TME subgroups were analyzed to explore the underlying molecular mechanism.

Results

We first identified the metastasis-related DEGs in osteosarcoma, which were primarily involved in the muscle system process, calcium ion homeostasis, cell chemotaxis, and leukocyte migration. A personalized MRS-TME classifier was then constructed by integrating the MRS (10 genes) and TME (six immune cells) scores. The MRS-TME classifier demonstrated a potent capacity of predicting the survival prognosis in diverse osteosarcoma cohorts as well as in the clinical feature subgroups. The MRS score was negatively associated with the TME score, and patients in the MRS^low/TME^high subgroup exhibited a better prognosis compared to all other subgroups. Significant differences existed between the cellular signaling pathways and immune response profiles among the different MRS-TME subgroups, especially in relation to the metabolism-related biological processes and the inflammatory response.

Conclusions

The MRS-TME classifier might be a beneficial tool to aid in the prognostic evaluation and risk stratification of osteosarcoma patients.

Effects of microenvironment in osteosarcoma on chemoresistance and the promise of immunotherapy as an osteosarcoma therapeutic modality

Osteosarcoma (OS) is one of the most common primary malignant tumors originating in bones. Its high malignancy typically manifests in lung metastasis leading to high mortality. Although remarkable advances in surgical resection and neoadjuvant chemotherapy have lengthened life expectancy and greatly improved the survival rate among OS patients, no further breakthroughs have been achieved. It is challenging to treat patients with chemoresistant tumors and distant metastases. Recent studies have identified a compelling set of links between hypoxia and chemotherapy failure. Here, we review the evidence supporting the positive effects of hypoxia in the tumor microenvironment (TME). In addition, certain anticancer effects of immune checkpoint inhibitors have been demonstrated in OS preclinical models. Continued long-term observation in clinical trials is required. In the present review, we discuss the mutualistic effects of the TME in OS treatment and summarize the mechanisms of immunotherapy and their interaction with TME when used to treat OS. We also suggest that immunotherapy, a new comprehensive and potential antitumor approach that stimulates an immune response to eliminate tumor cells, may represent an innovative approach for the development of a novel treatment regimen for OS patients.

Heparin and Heparin-Based Drug Delivery Systems: Pleiotropic Molecular Effects at Multiple Drug Resistance of Osteosarcoma and Immune Cells

One of the main problems of modern health care is the growing number of oncological diseases both in the elderly and young population. Inadequately effective chemotherapy, which remains the main method of cancer control, is largely associated with the emergence of multidrug resistance in tumor cells. The search for new solutions to overcome the resistance of malignant cells to pharmacological agents is being actively pursued. Another serious problem is immunosuppression caused both by the tumor cells themselves and by antitumor drugs. Of great interest in this context is heparin, a biomolecule belonging to the class of glycosaminoglycans and possessing a broad spectrum of biological activity, including immunomodulatory and antitumor properties. In the context of the rapid development of the new field of “osteoimmunology,” which focuses on the collaboration of bone and immune cells, heparin and delivery systems based on it may be of intriguing importance for the oncotherapy of malignant bone tumors. Osteosarcoma is a rare but highly aggressive, chemoresistant malignant tumor that affects young adults and is characterized by constant recurrence and metastasis. This review describes the direct and immune-mediated regulatory effects of heparin and drug delivery systems based on it on the molecular mechanisms of (multiple) drug resistance in (onco) pathological conditions of bone tissue, especially osteosarcoma.