Exosome-Based Liquid Biopsy Approaches in Bone and Soft Tissue Sarcomas: Review of the Literature, Prospectives, and Hopes for Clinical Application

Minimal Residual Disease in Metastatic Soft Tissue Sarcoma

OPINION STATEMENT

Liquid biopsies represent a promising and minimally invasive approach to diagnosing and monitoring cancer. In recent years, studies across a multitude of solid organ malignancies have suggested the clinical utility of biomarkers such as circulating tumor DNA (ctDNA). Particular attention has been given to serial assessment of such biomarkers in an effort to detect minimal residual disease (MRD), in order to predict which patients may be at highest risk of relapse following curative-intent surgical or medical intervention. Such investigations are particularly relevant to sarcomas, which are highly heterogeneous malignancies and commonly develop treatment resistance. While preliminary research described herein is promising, there remain key barriers to widespread adoption of liquid biopsy in sarcoma, including the lack of standardized detection methods, high cost, and the need for large, prospective studies to validate their clinical utility. Given the high level of interest in liquid biopsy in the biomedical community, it is plausible such obstacles may be overcome in the near future. With such advancements, one can anticipate that liquid biopsies may become a key tool in the sarcoma oncologists armamentarium, and offer a path toward improved outcomes for patients with sarcoma.

Personalized assessment and monitoring of bone health from sweat: unveiling TEGO doped wearable, non-invasive hydrogel nanocomposite biosensor empowered by IL-6 detection

Portable biosensing is crucial for rapid detection and continuous monitoring of bone diseases such as osteoporosis and bone cancer. It is well established that such bone disorders or diseases trigger release of inflammatory cytokines including interleukin-6 (IL6), detectable in sweat by electrochemical immunosensors. To this end, this study presents a novel hydrogel nanocomposite based immunosensor with highly conductive dual-layer of thermally exfoliated graphene oxide, toward precise detection and determination of loading level of IL-6 biomarker, and in turn, developing a label-free flexible bone biosensing platform. The immunosensor employed antibody immobilization process, which was further facilitated by the modification of the dual-layer by using 1-pyrenebutyric acid N-hydroxy succinimide ester. A thorough analysis of the effects of surface modification was conducted utilizing spectroscopic, electrochemical, and morphological methods. The biosensor's response was assessed through the utilization of the cyclic voltammetry measurement, which exhibited remarkable selectivity, achieving a low limit of detection of 15.4 pg ml-1across a wide linear range. Additionally, field emission scanning electron microscopy, Fourier transform infrared spectroscopy and Raman spectroscopy were successfully used to validate the sensing substrate in bio-fluidic samples and to understand the structure-property correlation. This innovative portable and flexible biosensor thus offers a practical and effective tool for potential application in continuous monitoring of bone health.

Role of exosomes in diagnosis, prognostication, and treatment of pediatric solid tumors

Cancer is the second leading cause of death in children, and solid tumors make up 30% of childhood cancers. Molecular profiling of pediatric solid tumors allows a personalized approach to therapy, but this approach mostly relies on surgical biopsy, which is invasive and carries the risk of complications. Liquid biopsy serves as a reliable alternative and a minimally invasive tool for diagnosing, prognosticating, and residual disease monitoring in childhood cancers. This review outlines the potential of exosomes as informative liquid biopsies in pediatric solid tumors. Studies highlighting the potential applications and clinical utility of exosomes and their molecular constituents as prognosticators and therapies in common childhood solid tumors, including neuroblastoma, medulloblastoma, sarcoma, and hepatoblastoma, have been overviewed. We also discuss the limitations and technical challenges of utilizing exosomes for pediatric solid tumors.

Advancements in Exosome Proteins for Breast Cancer Diagnosis and Detection: With a Focus on Nanotechnology

Breast cancer, a leading cause of mortality among women, has been recognized as requiring improved diagnostic methods. Exosome proteins, found in small extracellular vesicles, have emerged as a promising solution, reflecting the state of their cell of origin and playing key roles in cancer progression. This review examines their potential in breast cancer diagnosis, discussing advanced isolation and characterization techniques such as ultracentrifugation and microfluidic-based approaches. Various detection methods-including electrochemical, nano-based, optical, and machine learning platforms-were evaluated for their high sensitivity, specificity, and non-invasive capabilities. Electrochemical methods were used to identify unique protein signatures for rapid, cost-effective diagnosis, while machine learning enhanced the classification of exosome proteins. Nano-based techniques leveraged nanomaterials to detect low-abundance proteins, and optical methods offered real-time, label-free monitoring. Despite their promise, challenges in standardizing protocols and integrating these diagnostics into clinical practice remain. Future directions include technological advancements, personalized medicine, and exploring the therapeutic potential of exosome proteins.

Exosomes to exosome-functionalized scaffolds: a novel approach to stimulate bone regeneration

Bone regeneration is a complex biological process that relies on the orchestrated interplay of various cellular and molecular events. Bone tissue engineering is currently the most promising method for treating bone regeneration. However, the immunogenicity, stable and cell quantity of seed cells limited their application. Recently, exosomes, which are small extracellular vesicles released by cells, have been found to effectively address these problems and better induce bone regeneration. Meanwhile, a growing line of research has shown the cargos of exosomes may provide effective therapeutic and biomarker tools for bone repair, including miRNA, lncRNA, and proteins. Moreover, engineered scaffolds loaded with exosomes can offer a cell-free bone repair strategy, addressing immunogenicity concerns and providing a more stable functional performance. Herein, we provide a comprehensive summary of the role played by scaffolds loaded with exosomes in bone regeneration, drawing on a systematic analysis of relevant literature available on PubMed, Scopus, and Google Scholar database.

Nanoparticles-Delivered Circular RNA Strategy as a Novel Antitumor Approach

Anticancer therapy urgently needs the development of novel strategies. An innovative molecular target is represented by circular RNAs (circRNAs), single-strand RNA molecules with the 5' and 3' ends joined, characterized by a high stability. Although circRNA properties and biological functions have only been partially elucidated, their relationship and involvement in the onset and progression of cancer have emerged. Specific targeting of circRNAs may be obtained with antisense oligonucleotides and silencing RNAs. Nanotechnology is at the forefront of research for perfecting their delivery. Continuous efforts have been made to develop novel nanoparticles (NPs) and improve their performance, materials, and properties regarding biocompatibility and targeting capabilities. Applications in various fields, from imaging to gene therapy, have been explored. This review sums up the smart strategies developed to directly target circRNAs with the fruitful application of NPs in this context.

Exosomes: a promising avenue for cancer diagnosis beyond treatment

Exosomes, extracellular vesicles secreted by cells, have garnered significant attention in recent years for their remarkable therapeutic potential. These nanoscale carriers can be harnessed for the targeted delivery of therapeutic agents, such as pharmaceuticals, proteins, and nucleic acids, across biological barriers. This versatile attribute of exosomes is a promising modality for precision medicine applications, notably in the realm of cancer therapy. However, despite their substantial therapeutic potential, exosomes still confront challenges tied to standardization and scalability that impede their practice in clinical applications. Moreover, heterogeneity in isolation methodologies and limited cargo loading mechanisms pose obstacles to ensuring consistent outcomes, thereby constraining their therapeutic utility. In contrast, exosomes exhibit a distinct advantage in cancer diagnosis, as they harbor specific signatures reflective of the tumor's genetic and proteomic profile. This characteristic endows them with the potential to serve as valuable liquid biopsies for non-invasive and real-time monitoring, making possible early cancer detection for the development of personalized treatment strategies. In this review, we provide an extensive evaluation of the advancements in exosome research, critically examining their advantages and limitations in the context of cancer therapy and early diagnosis. Furthermore, we present a curated overview of the most recent technological innovations utilizing exosomes, with a focus on enhancing the efficacy of early cancer detection.

Beneath the Layers: Deciphering the Molecular Pathways, Therapeutic Avenues, and Neurological Connections of Soft Tissue Sarcomas

Soft tissue sarcomas (STSs) are a heterogeneous group of malignancies that have long posed challenges in terms of diagnosis, treatment, and management. This narrative review provides a comprehensive exploration into the multifaceted realm of STS, spanning from its historical origins to the latest advancements in research and clinical care. We delve into the molecular intricacies of STS, highlighting the genetic and epigenetic aberrations that drive these tumors. The review emphasizes the neurological implications of STS, a relatively underexplored area, shedding light on the interplay between tumor biology and neural processes. The evolving therapeutic landscape is discussed, with a focus on the promise of targeted therapies, immunotherapy, and precision medicine. A significant portion is dedicated to the patient-centric approach, underscoring the importance of holistic care that addresses both the physical and psychological needs of STS patients. Furthermore, we highlight the gaps in current research and clinical practices, offering insights into potential avenues for future exploration. This review serves as a valuable resource for clinicians, researchers, and the broader scientific community, encapsulating the current state of STS knowledge and pointing toward future directions in this dynamic field.