Research Progress of Nanomaterials in Chemotherapy of Osteosarcoma

FeS embedded bioreactor collaborate with artesunate for cascade-catalytic tumor ferroptosis

Ferroptosis, a non-apoptotic programmed cell death modality, has been recognized as an emerging therapeutic target for cancer treatment, particularly with the rapid advancements in bionanotechnology. However, the insufficient intracellular Fe2+ ions and low reactive oxygen species (ROS) production severely restrict the efficacy of ferroptosis at tumor sites. Herein, a pH-responsive multifunctional nanoplatform (p-COF@GOx-FeS@HA/ART) was constructed to achieve efficient tumor ferroptosis through self-supplied Fe2+ ions and amplified ROS. In this system, the large specific surface area and mesoporous structure enabled the porphyrin-based covalent organic frameworks (p-COFs) to act as scaffolds and drug carriers for enhancing the catalytic activity of glucose oxidase-stabilized ferrous sulfide nanodots (GOx@FeS) and encapsulation of artesunate (ART). By oxidizing glucose (Glu) in tumor cells, GOx not only consumed Glu for starvation therapy but also promoted intracellular acidity and supplied hydrogen peroxide (H2O2) in the tumor microenvironment (TME), which facilitated the FeS-mediated chemodynamic therapy (CDT) as well as the release of hydrogen sulfide (H2S) for accelerating the ROS generation. Moreover, the lowered acidic TME could simultaneously trigger the release of ART and Fe2+ ions, thus exacerbating ART-mediated ferroptosis. Due to its photothermal and photodynamic behavior, the nanoplatform under laser irradiation could generate ROS storms in tumor cells for high-performance ferroptosis therapy, which was demonstrated both in cancer cells and tumor-bearing mice. This work provides a promising strategy for the simple construction of a multifunctional nanoplatform with TME-responsive and self-triggered ferroptosis, showing great potential in cascade amplification of ferroptosis therapy.

3D-Printed Metacarpal Prosthesis in the Treatment of Primary Osteosarcoma of the First Metacarpal: A Novel Surgical Technique

OBJECTIVE

Osteosarcoma at the first metacarpal is extremely rare. Reconstructing the metacarpal after tumor resection is essential, as the thumb accounts for approximately 40%-50% of hand function. Although autografts, arthroplasty, and transposition have been reported as reconstruction options, their use is limited by complications such as secondary injury, nonunion, and displacement. In this study, we present a case of a patient with first metacarpal osteosarcoma who underwent tumor resection followed by reconstruction with a 3D-printed metacarpal prosthesis. We tend to introduce a novel strategy to reconstruct the first metacarpal and restore the hand function.

METHODS

A 30-year-old male with 5-month history of first metacarpal swelling in the left hand was admitted to our center. Imaging examinations and incision biopsy confirmed a diagnosis of intramedullary well-differentiated osteosarcoma. A 3D-printed metacarpal prosthesis was then designed to achieve carpometacarpal (CMC) joint fusion and thumb metacarpophalangeal (MCP) joint reconstruction. Postoperative evaluations included X-ray and tomosynthesis-shimadzu metal artifact reduction technology (T-SMART) imaging to assess bone-prosthesis integration. Hand function was measured using the Musculoskeletal Tumor Society (MSTS) score and the Disabilities of the Arm, Shoulder, and Hand (DASH) score.

RESULTS

The tumor was completely resected, and a 3D-printed metacarpal prosthesis was performed to reconstruct the tumor defect. Postoperative imaging showed that the interface between bone and prosthesis was integrated and that there was no loose, displacement, or fracture of the implant. At the last follow-up, the patient had an MSTS score of 25/30 and a DASH score of 8/100. The range of motion on thumb MCP joint was 30° of flexion and 0° of extension. The Kapandji thumb opposition score was 4 points. The grip strength was 9 kg (compared to 30 kg on the contralateral side) and the key-pinch strength was 3 kg (compared to 8 kg on the contralateral side).

CONCLUSION

3D-printed metacarpal prosthesis could be an effective reconstruction option for patients with low-grade malignant tumors. Themulti-planar fixation achieved through 3D surgical planning helps maintain thumb function and restore overall hand function.

Outcome, Complications, and Survival of Sarcomas of the Extremities Treated With Mega Prostheses: A Comprehensive Analysis of 115 Cases in a Cancer-Dedicated Hospital

INTRODUCTION

In the late 20th century, limb salvage surgery emerged as a game-changer for treating musculoskeletal tumors, evolving with advanced techniques to offer both survival and functional preservation. The objective of the study is to discuss key metrics, such as overall survival, metastasis-free survival, local recurrence-free survival, and functional outcomes, recognizing the importance of these measures. Despite hurdles such as potential infections and implant issues, it is crucial to understand and address complications, which is also highlighted in this study.

METHODS

This was a retrospective review of patients with primary malignant bone tumors from January 2017 to December 2023 and the progress was followed up till June 2024. Variables assessed included patient age, size and anatomical location of the primary tumor, metastasis, histological subtype, stage and grade of tumor, resection margins, treatment provided, functional outcome, and complications. The data were analyzed with SPSS version 27. Five-year metastasis-free survival, recurrence-free survival, and overall survival were analyzed by using the Kaplan-Meier method.

RESULTS

A total of 115 patients were analyzed, among which the most common type of tumor was osteosarcoma, found in 79 (68.7%) patients. Out of the 115 patients, 20 (17.4%) expired, six were lost to follow-up, and the five-year overall survival rate was approximately 78% (95% CI: 69.6-87.5%). Fourteen (12.2%) patients had local recurrence, and the five-year recurrence-free survival rate was approximately 83.2% (95% CI: 74.4-92.6%). Meanwhile, 27 (23.5%) patients had distant metastasis, and the five-year metastasis-free survival rate was approximately 67.5% (95% CI: 55.3-82.3%). Complications occurred in 31 (27%) patients, with 13 (11.3%) patients having local soft-tissue-related complications.

CONCLUSION

We observed good survival and functional outcomes in patients treated with wide-margin excision of bone sarcomas and reconstruction with mega prostheses.

Spatially Resolved Defect Characterization and Fidelity Assessment for Complex and Arbitrary Irregular 3D Printing Based on 3D P-OCT and GCode

To address the challenges associated with achieving high-fidelity printing of complex 3D bionic models, this paper proposes a method for spatially resolved defect characterization and fidelity assessment. This approach is based on 3D printer-associated optical coherence tomography (3D P-OCT) and GCode information. This method generates a defect characterization map by comparing and analyzing the target model map from GCode information and the reconstructed model map from 3D P-OCT. The defect characterization map enables the detection of defects such as material accumulation, filament breakage and under-extrusion within the print path, as well as stringing outside the print path. The defect characterization map is also used for defect visualization, fidelity assessment and filament breakage repair during secondary printing. Finally, the proposed method is validated on different bionic models, printing paths and materials. The fidelity of the multilayer HAP scaffold with gradient spacing increased from 0.8398 to 0.9048 after the repair of filament breakage defects. At the same time, the over-extrusion defects on the nostril and along the high-curvature contours of the nose model were effectively detected. In addition, the finite element analysis results verified that the 60-degree filling model is superior to the 90-degree filling model in terms of mechanical strength, which is consistent with the defect detection results. The results confirm that the proposed method based on 3D P-OCT and GCode can achieve spatially resolved defect characterization and fidelity assessment in situ, facilitating defect visualization and filament breakage repair. Ultimately, this enables high-fidelity printing, encompassing both shape and function.

Extracellular Vesicles Derived From 3D Cultured Antler Stem Cells Serve as a New Drug Vehicle in Osteosarcoma Treatment

Extracellular vesicles (EVs) from antler reserve mesenchymal (RM) cells play an important role in the paracrine regulation during rapid growth of antler without forming a tumor; therefore, RM-EVs become novel materials for anti-tumor studies, such as osteosarcoma treatment. However, the problem of low production of RM-EVs in traditional 2D culture limits its mechanism research and application. In this study, we established an optimal 3D culture system for antler RM cells to produce EVs (3D-RM-EVs). Morphology and property of harvested 3D-RM-EVs were normal compared with EVs from conventional 2D culture, and the miRNA profile in them was basically the same through transcriptome sequencing analysis. Based on the same number of RM cells, the volume of the culture medium collected by 3D cultural system concentrated nearly 30 times, making it more convenient for subsequent purification. In addition, EVs were harvested 30 times in 3D cultural system, greatly increasing the total amount of EVs (harvested a total of 2-3 times in 2D culture). Although 3D-RM-EVs had a limited inhibitory effect on the proliferation of K7M2 cells, the inhibition effect of 3D-RM-EVs loaded drugs (Ifosfamide + Etoposide) were more significant than that of positive drug group alone (P < 0.05). Furthermore, in vivo studies showed that 3D-RM-EVs loaded drugs (Ifosfamide + Etoposide) had the most significant tumor inhibition effect, with decreased tumor size, and could slow down body weight loss compared with Ifosfamide + Etoposide (IFO + ET) group. These results demonstrated that 3D-RM-EVs were efficiently prepared from antler RM cells and were effective as drug vehicles for the treatment of osteosarcoma.