Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation

BackgroundOsteosarcoma is the most prevalent among primary bone malignancies, and its standard intervention involves neoadjuvant chemotherapy - surgical adjuvant chemotherapy (MAP regimen) with adriamycin, cisplatin, and high-dose methotrexate. Early-stage osteosarcoma can be effectively treated wit...

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Main Authors: Xuehong Liu, Jingyao Ye, Wenlong Guo, Junqing Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Cell and Developmental Biology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcell.2024.1473044/full
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author Xuehong Liu
Jingyao Ye
Jingyao Ye
Wenlong Guo
Wenlong Guo
Junqing Wang
author_facet Xuehong Liu
Jingyao Ye
Jingyao Ye
Wenlong Guo
Wenlong Guo
Junqing Wang
author_sort Xuehong Liu
collection DOAJ
description BackgroundOsteosarcoma is the most prevalent among primary bone malignancies, and its standard intervention involves neoadjuvant chemotherapy - surgical adjuvant chemotherapy (MAP regimen) with adriamycin, cisplatin, and high-dose methotrexate. Early-stage osteosarcoma can be effectively treated with surgical resection along with chemotherapy or radiotherapy. However, as the cancer progresses, the efficacy of chemo- and radiotherapy decreases, and the associated problems increase. The current understanding of osteosarcoma development, diagnosis, and treatment does not meet clinical demands. More recently, there has been a significant increase in exosome-associated osteosarcoma research, potentially opening up novel possibilities for osteosarcoma research.PurposeWe comprehensively evaluated and analyzed the advancement of preclinical research related to exosome-osteosarcoma. We aimed to establish a practical, theoretical foundation for future research initiatives.Study designThe selected design was a systematic review and meta-analysis.MethodsScientific databases, such as PubMed, Embase, The Cochrane Library, and Web of Science, were extensively screened for exosome and osteosarcoma articles. Two highly trained investigators separately reviewed the literature, extracted relevant information, and assessed study quality. Subsequently, we conducted a meta-analysis using Review Manager 5.4.ResultsIn total, 25 animal-based randomized controlled trials (RCTs) were selected for analysis. Among them, 13 studies provided strong evidence of cellular exosomes regulating osteosarcoma development from bone marrow mesenchymal stem cells, osteosarcoma cells, and macrophages. In addition, 12 studies demonstrated the therapeutic potential of exosomes in managing osteosarcoma, among which 7 studies transplanted transfected exosomes directly into animals as drugs, and five studies employed exosomes as drug carriers, which were next transplanted into animals.ConclusionBased on our meta-analysis, macrophages strongly modulate osteosarcoma development, and engineered exosomes provide the most effective exosome-based osteosarcoma treatment.
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spelling doaj-art-4d4252535f664536aeddf33db7ea0f152025-08-20T02:14:56ZengFrontiers Media S.A.Frontiers in Cell and Developmental Biology2296-634X2024-11-011210.3389/fcell.2024.14730441473044Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigationXuehong Liu0Jingyao Ye1Jingyao Ye2Wenlong Guo3Wenlong Guo4Junqing Wang5Institute of Integrated Traditional Chinese and Western Medicine, Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaClinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaClinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Orthopedics, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaBackgroundOsteosarcoma is the most prevalent among primary bone malignancies, and its standard intervention involves neoadjuvant chemotherapy - surgical adjuvant chemotherapy (MAP regimen) with adriamycin, cisplatin, and high-dose methotrexate. Early-stage osteosarcoma can be effectively treated with surgical resection along with chemotherapy or radiotherapy. However, as the cancer progresses, the efficacy of chemo- and radiotherapy decreases, and the associated problems increase. The current understanding of osteosarcoma development, diagnosis, and treatment does not meet clinical demands. More recently, there has been a significant increase in exosome-associated osteosarcoma research, potentially opening up novel possibilities for osteosarcoma research.PurposeWe comprehensively evaluated and analyzed the advancement of preclinical research related to exosome-osteosarcoma. We aimed to establish a practical, theoretical foundation for future research initiatives.Study designThe selected design was a systematic review and meta-analysis.MethodsScientific databases, such as PubMed, Embase, The Cochrane Library, and Web of Science, were extensively screened for exosome and osteosarcoma articles. Two highly trained investigators separately reviewed the literature, extracted relevant information, and assessed study quality. Subsequently, we conducted a meta-analysis using Review Manager 5.4.ResultsIn total, 25 animal-based randomized controlled trials (RCTs) were selected for analysis. Among them, 13 studies provided strong evidence of cellular exosomes regulating osteosarcoma development from bone marrow mesenchymal stem cells, osteosarcoma cells, and macrophages. In addition, 12 studies demonstrated the therapeutic potential of exosomes in managing osteosarcoma, among which 7 studies transplanted transfected exosomes directly into animals as drugs, and five studies employed exosomes as drug carriers, which were next transplanted into animals.ConclusionBased on our meta-analysis, macrophages strongly modulate osteosarcoma development, and engineered exosomes provide the most effective exosome-based osteosarcoma treatment.https://www.frontiersin.org/articles/10.3389/fcell.2024.1473044/fullosteosarcomaexosomespreclinical studiesmeta-analysischemotherapy
spellingShingle Xuehong Liu
Jingyao Ye
Jingyao Ye
Wenlong Guo
Wenlong Guo
Junqing Wang
Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
Frontiers in Cell and Developmental Biology
osteosarcoma
exosomes
preclinical studies
meta-analysis
chemotherapy
title Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
title_full Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
title_fullStr Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
title_full_unstemmed Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
title_short Significance of exosomes in osteosarcoma research: a systematic review and meta-analysis of a singular clinical investigation
title_sort significance of exosomes in osteosarcoma research a systematic review and meta analysis of a singular clinical investigation
topic osteosarcoma
exosomes
preclinical studies
meta-analysis
chemotherapy
url https://www.frontiersin.org/articles/10.3389/fcell.2024.1473044/full
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