The Use of Hydrogels for the Treatment of Bone Osteosarcoma via Localized Drug-Delivery and Tissue Regeneration: A Narrative Review

Abstract

Osteosarcoma is a malignant tumor of bone that leads to poor mortality and morbidity. Management of this cancer through conventional methods involves invasive treatment options that place patients at an increased risk of adverse events. The use of hydrogels to target osteosarcoma has shown promising results both in vitro and in vivo to eradicate tumor cells while promoting bone regeneration. The loading of hydrogels with chemotherapeutic drugs provides a route for site-specific targeted therapy for osteosarcoma. Current studies demonstrate tumor regression in vivo and lysis of tumor cells in vitro when exposed to doped hydrogel scaffolds. Additionally, novel stimuli-responsive hydrogels are able to react with the tissue microenvironment to facilitate the controlled release of anti-tumor drugs and with biomechanical properties that can be modulated. This narrative review of the current literature discusses both in vitro and in vivo studies of different hydrogels, including stimuli-responsive, designed to treat bone osteosarcoma. Future applications to address patient treatment for this bone cancer are also discussed.

Mesenchymal Stem/Stromal Cells: Immunomodulatory and Bone Regeneration Potential after Tumor Excision in Osteosarcoma Patients

“…In addition to other biomaterials, hydrogels, with their biocompatibility, bioactivity, biodegradability, and osteoinductive attributes, hold promise in targeting residual tumor areas within bone defects and promoting the natural regeneration of bone at the injury site [97]. These biomimetic hydrogels closely resemble the extracellular matrix (ECM), providing vital support for the proliferation and differentiation of MSCs into osteoblasts, ultimately facilitating the restoration of lost bone tissue [97][98][99][100].…”

A Binary Survivability Prediction Classification Model towards Understanding of Osteosarcoma Prognosis

“…This unique characteristic enables the loading of therapeutic compounds onto the hydrogel in its liquid form, which can then be easily solidified and administered when applied. These advancements have opened doors for developing targeted hydrogels to combat osteosarcoma, aiming to induce tumor cell death and enhance survivability in patients [12]. Another study revealed a significant correlation between age and survival rate in elderly patients, demonstrating that advancing age is associated with reduced survivability.…”

“…While data on the United States' Surveillance, Epidemiology, and End Results (SEER) program indicates a similar 5-year survival rate of 19% for lung cancer as well as 18% for liver cancer [14,15]. However, osteosarcoma is not necessarily the highest in rank for survivability among cancers of the vital organs; American kidney cancer patients have been found to experience a 5-year relative survival rate of about 75% [12]. As for comparisons against cancers of nonvital organs, osteosarcoma is often outclassed in terms of survival rates as these non-vital organs can often be removed to eliminate the cancer from the patient's body.…”

“…As for comparisons against cancers of nonvital organs, osteosarcoma is often outclassed in terms of survival rates as these non-vital organs can often be removed to eliminate the cancer from the patient's body. For instance, the same SEER data indicates that female breast cancer has a relative 5-year survival rate of 90% and prostate cancer has a survival rate of 98% [12]. Nevertheless, gaining the ability to make more accurate survivability predictions for osteosarcoma patients is indispensable in ensuring that the patients are given a clearer picture of what to expect from the disease.…”