Advancements in research regarding the influence of the tumor microenvironment on the proliferation and metastasis of osteosarcoma (Review).

Osteosarcoma (OS), a common primary malignant bone tumor in children and young adults, is significantly influenced by a complex tumor microenvironment (TME) that includes bone cells, stromal cells, vascular cells, immune cells and a mineralized extracellular matrix (ECM). In recent years, the role of the TME in OS progression has garnered increasing attention. The TME not only provides the physical and biochemical support necessary for tumor cell growth, invasion and metastasis, but also promotes the maintenance of the malignant tumor phenotype through mechanisms such as immune suppression, angiogenesis and metabolic reprogramming. The present review discusses how various cellular and non-cellular components within the OS TME interact to drive tumor progression. Consequently, targeting the TME has emerged as a promising therapeutic strategy to overcome the limitations of conventional treatments, particularly for metastatic or recurrent OS. The present review underscores the potential of TME-targeted therapies and highlights the need for further research into the heterogeneity of the TME to improve clinical outcomes.