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Advances in Soft Tissue and Bone Sarcoma (2nd Edition)

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 25 June 2026 | Viewed by 9166

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Dr. Catrin Sian Rutland

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School of Veterinary Medicine and Science, University of Nottingham, Nottingham LE12 5RD, UK
Interests: osteosarcoma; biomarkers; histopathology
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Dear Colleagues,

This Special Issue is the second edition of a previous Special Issue entitled “Advances in Soft Tissue and Bone Sarcoma” https://www.mdpi.com/journal/cancers/special_issues/C8D9NZ20HW.

Sarcomas represent a broad range of both soft tissue sarcomas and bone sarcomas. Although they represent around 1% of human malignancies, they form the second most common solid-tumor type in children. With over 100 histologic subtypes, they represent a diverse group of mesenchymal malignancies. Despite recent advances, bone and soft tissue sarcomas often exhibit poor responses to treatments and less favorable survival rates, especially in advanced, refractory, metastatic, or relapsed sarcomas. They are also clinically challenging, with limited treatment options due to the complexity and rarity of many of the subtypes, in addition to chemotherapy resistance in some cases. This Special Issue aims to cover advances in surgery and adjunct therapies, imaging, histological and pathological discoveries, and research into molecular pathways. From biomarkers assisting diagnosis and prognosis through to the discovery of novel therapeutic targets, this Special Issue highlights the latest discoveries in bone and soft tissue sarcomas.

We are pleased to invite you to contribute to this Special Issue on bone and soft tissue sarcomas. Despite advances in clinical and basic research, soft tissue and bone sarcomas remain clinically challenging. This Special Issue aims to highlight the latest discoveries in soft tissue and bone cancers from the laboratory through to the clinic, bench to bedside, and beyond. It will bring together original research and reviews covering any subtype of bone or soft tissue sarcoma on topics ranging from detection and diagnosis methods using histopathology, imaging, and molecular advances through to treatment and prognosis, including epidemiological studies, outcome analysis, and surgical and adjunct treatments.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: research into the detection, treatment, and outcomes of chondrosarcoma, Ewing sarcoma, osteosarcoma, fibrosarcoma, gastrointestinal stromal tumors, leiomyosarcoma, liposarcoma, rhabdomyosarcoma, undifferentiated pleomorphic sarcoma, synovial sarcoma, and any other type of bone or soft tissue sarcoma in people, animals, and different models.

Dr. Catrin Sian Rutland
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

bone sarcoma
soft tissue sarcoma
prognosis
diagnosis
detection
molecular biomarkers
histopathology
treatment

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Published Papers (11 papers)

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16 pages, 1663 KB

Open AccessArticle

A Predictive MRI Radiomics Model for Histologic Differentiation in Soft Tissue Sarcomas

by Laetitia Perronne, Nicolò Gennaro, Zuzanna Kobus, Mirinae Seo, Amir A. Borhani, Linda Kelahan, Hatice Savas, Ryan Avery, Kamal Subedi, Chase Krumpelman, Gorkem Durak, Ulas Bagci, Akhil Chawla, Borislav Alexiev, Pedro Hermida de Viveiros, Seth Pollack and Yuri S. Velichko

Cancers 2026, 18(10), 1667; https://doi.org/10.3390/cancers18101667 - 21 May 2026

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Abstract

Background/Objectives: The aim of this study was to develop and validate a robust, radiomics-based classification model that uses pre-treatment MRI to non-invasively differentiate among major soft tissue sarcoma (STS) subtypes and a benign mimic. Methods: In this retrospective study, a cohort of 332 patients with biopsy-proven leiomyosarcoma, myxofibrosarcoma, myxoid liposarcoma, dedifferentiated liposarcoma, and undifferentiated pleomorphic sarcoma, along with the benign mimic intramuscular myxoma, was analyzed. Pre-treatment T1-weighted fat-saturated contrast-enhanced and T2-weighted fat-saturated MRI sequences were used for analysis. Following manual tumor segmentation, 1240 three-dimensional radiomic features were extracted. An XGBoost classifier was trained and validated using a robust 250-iteration bootstrap framework with nested cross-validation to ensure rigorous feature selection and unbiased performance evaluation. The model’s performance was assessed independently on T1-only, T2-only, and combined T1+T2 feature sets. Results: The combined T1 and T2 model achieved superior performance with an accuracy of 0.68 ± 0.04 and an AUC of 0.92 ± 0.02. At the subtype level, balanced accuracy was highest for intramuscular myxoma (0.91 ± 0.05), dedifferentiated liposarcoma (0.84 ± 0.06), and leiomyosarcoma (0.83 ± 0.05). SHAP analysis identified key features driving predictions, such as low T2 GLSZM Zone Size Entropy for myxoma and high T2 GLSZM Gray-Level Variance for leiomyosarcoma, which aligns with known pathological characteristics. Misclassifications predominantly occurred between subtypes with overlapping radiomic profiles. Conclusions: Radiomics applied to pre-treatment MRI enables robust, non-invasive classification of STS subtypes, demonstrating strong clinical potential for improving diagnostic confidence and informing triage strategies. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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12 pages, 3983 KB

Open AccessArticle

Revision-Free Survival After MUTARS Total Knee Reconstruction in Limb Salvage Surgery: Primary Implantation Versus Conversion

by Fabian Hille, Jan Christoph Theil, Georg Gosheger, Tymoteusz Budny, Marieke de Vaal, Anna Maria Rachbauer and Niklas Deventer

Cancers 2026, 18(9), 1408; https://doi.org/10.3390/cancers18091408 - 29 Apr 2026

Viewed by 341

Abstract

(1) Background: Megaprosthetic reconstruction of the knee is frequently required in limb salvage surgery for oncologic indications and in complex revision arthroplasty. The Modular Universal Tumor and Revision System (MUTARS) Total Knee prosthesis is widely used in these situations. The aim of this study was to evaluate revision-free implant survival following MUTARS Total Knee implantation and to compare outcomes between primary implantation and use as a conversion procedure after failure of a previous knee prosthesis. (2) Methods: A retrospective cohort study was performed including 36 patients who underwent MUTARS Total Knee implantation at a single institution. Patients were stratified into primary implantation (n = 24) and conversion after failed prosthesis (n = 12). The primary endpoint was time to first revision. (3) Results: Overall revision-free survival was 51.6% at 2 years and 29.3% at 5 years. No significant difference in revision-free survival was observed between primary implantation and conversion procedures (log-rank p = 0.67). When mechanical failure (Henderson type III) was considered as the sole endpoint, implant survival was substantially higher, with 88.3% survival at 2 years and 57.2% at 5 years. Infection-related implant survival was 72.0% at both 2 and 5 years. Secondary amputation was required in 7 of 36 patients (19.4%), with a higher proportion observed in the primary implantation group (25.0% vs. 8.3%). Most amputations occurred within the early postoperative period. (4) Conclusions: MUTARS Total Knee implantation is associated with a substantial revision burden; however, conversion after failed prosthesis did not result in inferior revision-free survival compared with primary implantation. Endpoint-specific analyses demonstrate that biological complications, particularly infection, represent the dominant drivers of early failure. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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14 pages, 771 KB

Open AccessArticle

Multidisciplinary Treatment of Inguinoscrotal Sarcomas: Analysis of 39 Cases Treated by Surgical Approach

by Roger Homs Samsó, Lorena Cambeiro Cabré, Sandra González Abós, Mireia Solans Solerdelcoll, Katarina Majercakova, Ana Sebio García, Isidre Gracia Alegria, Manuel Fernández Garrido, Antonio Moral Duarte and José Antonio González López

Cancers 2026, 18(5), 876; https://doi.org/10.3390/cancers18050876 - 9 Mar 2026

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Abstract

Background: Inguinoscrotal sarcomas are a rare sarcoma subtype. The treatment of choice is radical inguinal orchiectomy with wide local resection of the surrounding soft tissues. However, consensus regarding prognostic factors is lacking. We present our experience at a referral sarcoma center concerning the management, oncologic results, and prognostic factors pertaining to this disease. Methods: We conducted a retrospective analysis of patients who underwent surgery for inguinoscrotal sarcomas between 2005 and 2023 at a sarcoma referral hospital. Results: The study included 39 patients. The most frequent histology was liposarcoma. Seven patients required surgical reconstruction with a microvascularized free flap. Four patients presented major postoperative complications. Mean follow-up was 46 months. Overall survival rates were 97.4%, 81.7%, and 64.8% at one, three, and five years. High-grade tumors were correlated with worse overall and disease-free survival. Conclusions: The chance finding of a sarcoma in the inguinal region poses a diagnostic and therapeutic dilemma when considering options for treatment with curative intent. Vascular and muscle resection followed by vascular and/or free flap reconstruction may be necessary to achieve complete surgical resections; therefore, a multidisciplinary approach is needed. A preoperative biopsy should be performed to establish the histological grade, which may be the main prognostic factor. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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14 pages, 1121 KB

Open AccessArticle

Pelvic Osteosarcoma: Outcomes of Surgically Treated Patients in a Retrospective Single-Center Study

by Tymoteusz Budny, Jan Christoph Theil, Georg Gosheger, Nils Deventer, Marieke de Vaal, Anna Maria Rachbauer and Niklas Deventer

Cancers 2026, 18(5), 738; https://doi.org/10.3390/cancers18050738 - 25 Feb 2026

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Abstract

(1) Background: Pelvic osteosarcoma accounts for a small proportion of osteosarcoma cases but is associated with significantly poorer outcomes than extremity tumors. This study evaluates contemporary survival outcomes and prognostic factors in a single-center cohort. (2) Methods: We retrospectively analyzed 56 patients with primary pelvic osteosarcoma treated between 2006 and 2019. Demographic characteristics, surgical margins, adjuvant therapies, local recurrence, metastasis, survival outcomes and the Musculoskeletal Tumor Society (MSTS) Score were assessed. Kaplan–Meier analysis was performed for overall survival (OS), including subgroup analyses by age and Enneking classification. (3) Results: Median age at surgery was 24 years. R0 margins were achieved in 96.4% of cases. OS at 1, 3, and 5 years was 69%, 54%, and 48%, respectively. Younger patients (≤25 years) showed significantly improved 5-year OS (68%) compared with older groups. Enneking classification showed limited prognostic discrimination. Metastatic disease at any time strongly predicted inferior survival (5-year OS 30% vs. 66%). The mean MSTS score one year after operation was 14.1 points. Functional outcome showed marked variability and was strongly influenced by patient age, extent of resection, reconstruction strategy, and postoperative complications. Younger patients and those undergoing limited or non-acetabular reconstructions achieved superior functional results, whereas complex endoprosthetic reconstructions and revision-requiring complications were associated with reduced MSTS scores. (4) Conclusions: Pelvic osteosarcoma continues to be associated with substantial morbidity and mortality. Younger age and absence of metastatic disease are strong predictors of improved survival. Functional outcomes are typically moderate; further advances are needed to improve results. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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23 pages, 6117 KB

Open AccessArticle

Identification and Characterisation of Canine Osteosarcoma Biomarkers and Therapeutic Targets

by Jorja Jackson-Oxley, Aziza A. Alibhai, Rachel Thompson, Jennifer Lothion-Roy, Simone de Brot, Mark D. Dunning, Jennie N. Jeyapalan, Nigel P. Mongan and Catrin S. Rutland

Cancers 2026, 18(2), 262; https://doi.org/10.3390/cancers18020262 - 14 Jan 2026

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Abstract

Background: Osteosarcoma (OSA) is the most common type of bone cancer in canines. Novel therapies are required to prevent the growth, survival, and metastatic progression of this cancer, to increase life expectancy of patients. Immunohistochemical (IHC) studies and RNA sequencing help us gain a deeper understanding into the molecular mechanisms of the disease. Methods: We previously compared canine OSA tissues with patient matched non-tumour tissues, revealing 442 overexpressed genes within the samples. The present research used IHC staining for four of these genes in OSA tissues: G protein-coupled receptor 64 (GPR64), TOX High Mobility Group Box Family Member 3 (TOX3), Matrix Metallopeptidase 12 (MMP-12), and Forkhead Box F1 (FOXF1). H-scoring was performed to quantitatively assess protein expression and qualitatively contextualise staining locations. Additional analyses addressed whether gender or anatomical location of lesions (axial or appendicular tumours) affected protein expression. cBioPortal was employed to analyse expression and genetic alterations in patients. Results: GPR64, TOX3, MMP-12, and FOXF1 showed high mRNA expression and genetic alterations in people with OSA. GPR64, TOX3, MMP-12, and FOXF1 were all expressed in canine OSA with novel findings regarding cellular expression. Additionally, differential sex expression was revealed for GPR64 and TOX3. Potential biomarkers or therapeutic targets were identified. Conclusions: These studies, and subsequent analysis, have provided insights into the molecular mechanisms associated with OSA progression and revealed potential biomarkers for diagnostic and prognostic purposes. A deeper understanding of genetic and protein interactions will support and progress novel pathways towards diagnostic, prognostic, and treatment interventions for OSA in both veterinary and human medicine. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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16 pages, 4408 KB

Open AccessArticle

Total Quadriceps Resection in High-Grade Soft-Tissue Sarcomas of the Thigh: Surgical Technique and Long-Term Functional Outcomes in Surviving Patients

by Luis Rafael Ramos Pascua, Paula Casas Ramos, Rubén Álvarez García, Sergio Sánchez Herráez, Cristina Ojeda Thies, Maximiliano Eugenio Negri, Daniel Bustamante Recuenco and Jesús Enrique Vilá Rico

Cancers 2026, 18(1), 37; https://doi.org/10.3390/cancers18010037 - 22 Dec 2025

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Abstract

Background: Reconstruction of the thigh extensor mechanism following wide excision of a soft-tissue sarcoma is difficult. The aim of this study was to describe the outcomes following complete quadriceps resection for large high-grade soft-tissue sarcomas. Methods: Ten patients with AJCC grade IIIB soft-tissue sarcomas of the anterior thigh were treated with total wide margin quadricectomy, with a mean follow-up of 4 years (range: 51–163 months) in the five surviving patients with conservative surgical procedures. The minimum follow-up period for four of these patients was 8 years. The extensor mechanism was reconstructed with local muscle transfers (eight cases) or a neurotized free flap of the contralateral vastus lateralis (two cases). Results: Four patients died, two due to non-tumor related causes and two due to metastatic disease at 50 months and 43 months. The remaining six were alive and disease-free at the final follow-up. All patients received surgical revision due to wound necrosis. Another patient required an external hemipelvectomy due to early local recurrence of the disease. Functional results of the five patients who remained alive and retained their limb were good or excellent in two cases, acceptable in one, and poor in two, according to their MSTS scores. Average knee flexion was 80° (range: 10–150°). Passive extension was complete in all cases, though no patients achieved it actively. Extensor strength was 2/5 in four patients and 4/5 in the other. Conclusion: Total quadricectomy for high-grade soft-tissue sarcomas of the anterior thigh compartment ensures wide resection margins and local disease control, although local wound complications are common, particularly in older patients. Resection appears to be technically easier if performed distally to proximally in the thigh. Local muscle transfers are more suited for low-demand patients, while neurotized free muscle flaps are mainly an option for young, motivated patients. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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20 pages, 5082 KB

Open AccessArticle

Oncolytic Maraba Virus MG1 Mediates Direct and Natural Killer Cell-Dependent Lysis of Ewing Sarcoma

by Tyler Barr, Victoria A. Jennings, Elizabeth A. Roundhill, Richard T. Baugh, Maisa Yamrali, Heather E. Owston, Dennis McGonagle, Peter V. Giannoudis, Natasha J. Caplen, Javed Khan, John C. Bell, Susan A. Burchill, Fiona Errington-Mais and Graham P. Cook

Cancers 2025, 17(20), 3319; https://doi.org/10.3390/cancers17203319 - 14 Oct 2025

Viewed by 1596

Abstract

Background: Ewing sarcoma (EWS) is a rare cancer of the bone and soft tissue, most prevalent in children and young adults. The treatment of EWS has progressed relatively little in over 30 years. Survival rates for patients, particularly those with metastatic and/or relapsed disease remain poor, highlighting the urgent need for innovative treatment options. Methods: Here, we have explored the therapeutic potential of the oncolytic Maraba virus strain MG1 using various in vitro models of EWS, including established cell lines, doxorubicin-resistant derivatives, spheroid cultures and primary patient-derived Ewing sarcoma cell cultures. We examined the direct oncolytic activity of MG1 and its ability to stimulate the immune-mediated killing of EWS by human healthy donor peripheral blood mononuclear cells. Results: We show that MG1 undergoes productive replication and exerts direct oncolysis of established EWS cell lines, doxorubicin-resistant EWS cell lines and patient-derived Ewing sarcoma cell cultures more recently established from tumours. In contrast, primary mesenchymal stem cells (the likely cell of origin of EWS) were resistant to MG1, with IFN-I being a major determinant of tumour cell selectivity. MG1-treated PBMC produced IFN-I and killed EWS cells in vitro, in a natural killer (NK) cell-dependent manner. Conclusions: The ability of MG1 to kill EWS cells directly and stimulate NK cell cytotoxicity against this tumour suggests that MG1 may provide therapeutic benefit for EWS patients where the efficacy of conventional treatments is currently limited. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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16 pages, 685 KB

Open AccessArticle

Long-Term Outcomes Following Reconstruction of Diaphyseal Defects of the Upper and Lower Extremities Using Diaphyseal Implants: A Retrospective Study with Focus on Fixation Technique

by Tymoteusz Budny, Anna Maria Rachbauer, Georg Gosheger, Felix Lückel, Marieke De Vaal, Sebastian Klingebiel, Jan Christoph Theil and Niklas Deventer

Cancers 2025, 17(18), 3059; https://doi.org/10.3390/cancers17183059 - 19 Sep 2025

Viewed by 990

Abstract

Background: The reconstruction of diaphyseal bone defects following tumor resection offers various biological and endoprosthetic treatment options. The present study analyzes the impact of the fixation method (cemented; uncemented; with locking screw; without locking screw) of the diaphyseal implant on clinical outcomes. Factors such as patient age and weight as well as tumor type and location are also considered. Methods: This study included 39 patients who underwent intercalary endoprosthetic reconstruction of the humerus (n = 4); femur (n = 29); and tibia (n = 6) between 1998 and 2020. Prosthetic complications, fixation methods and the MSTS score for functional outcome were statistically analyzed using SPSS and R. Results: The event-free probability in the competing risk model was 61% (95% CI 43–74%) after one year and 11% (95% CI 3–28%) after five years. The complication rate in the patient cohort was 54%. Cementless prosthesis fixation was associated with a statistically significant better functional outcome. Additionally, higher body weight and older patient age were associated with lower MSTS scores. Conclusions: Patients requiring rapid remobilization or adjuvant radiation therapy may benefit more from diaphyseal implants compared to biological reconstructions. However, the complication and revision rates of diaphyseal implants are elevated. The chosen fixation method shows a statistically significant influence on functional outcome. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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21 pages, 2309 KB

Open AccessReview

The Evolving Landscape of Systemic Therapy for Liposarcoma

by Hee Kyung Kim, Akshat Sarkari and Warren A. Chow

Cancers 2026, 18(11), 1694; https://doi.org/10.3390/cancers18111694 - 22 May 2026

Viewed by 114

Abstract

Background/Objectives: Liposarcoma represents a heterogeneous group of mesenchymal malignancies with distinct molecular profiles and clinical behaviors. While localized disease is managed with surgical resection, advanced or metastatic liposarcoma poses a significant therapeutic challenge due to limited response to traditional cytotoxic chemotherapy. This review summarizes current evidence-based systemic therapies and highlights recent advances in subtype-driven treatment strategies. Methods: We review key clinical trials supporting the use of anthracycline regimens, trabectedin, eribulin, and nuclear export inhibition with selinexor, as well as emerging targeted approaches directed at MDM2 and CDK4 amplification. In addition, we discuss the evolving role of immunotherapy, including checkpoint inhibitors and engineered T-cell receptor therapies targeting cancer–testis antigens. Results: Integrating molecular biology with therapeutic development, we emphasize the importance of histologic and genomic classification in guiding treatment selection and clinical trial design. Conclusion: Continued progress in biomarker-driven strategies and rational combination therapies is expected to further refine personalized treatment approaches and improve outcomes for patients with advanced liposarcoma. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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12 pages, 239 KB

Open AccessReview

Systemic Therapies for Desmoid Tumors: A Review of Past, Present, and Future Treatments

by Skylar L. Nahi and Amanda M. Dann

Cancers 2026, 18(10), 1521; https://doi.org/10.3390/cancers18101521 - 9 May 2026

Viewed by 392

Abstract

Desmoid tumors (DTs) are rare, fibroblastic neoplasms characterized by locally aggressive behavior, unpredictable clinical trajectories, and a substantial impact on patient quality of life despite minimal metastatic potential. Although the underlying biology of DTs remains incompletely defined, associations with prior trauma, hormonal exposure, and aberrant Wnt/β-catenin signaling—including somatic CTNNB1 mutations and germline APC alterations seen in Familial Adenomatous Polyposis—have informed both historical and contemporary therapeutic approaches. Management strategies have evolved from surgery-dominant paradigms toward individualized, multimodal treatment algorithms emphasizing systemic medical therapy, as reflected in current NCCN and Desmoid Tumor Working Group recommendations. This review focuses on the medical management of DTs, tracing the evolution from earlier noncytotoxic therapies, including antiestrogen agents such as tamoxifen, to modern systemic options supported by prospective and randomized data. We summarize available evidence for four principal classes of medical therapy: nonsteroidal anti-inflammatory drugs, cytotoxic chemotherapy (with particular emphasis on anthracycline-based regimens), tyrosine kinase inhibitors—most notably sorafenib—and the emerging class of γ-secretase inhibitors. Recent phase III data supporting the efficacy of nirogacestat highlight a shift toward mechanism-based, targeted treatment with demonstrable benefits in progression-free survival, symptom control, and patient-reported outcomes. Collectively, these advances underscore a maturing therapeutic landscape in which systemic therapy plays a central role in disease control, symptom palliation, and preservation of function for patients with advanced desmoid tumors. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

17 pages, 277 KB

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Harnessing miRNA-Containing Extracellular Vesicles from Mesenchymal Stromal Cell-Derived Extracellular Vesicles for Regeneration of Bone Defects: A Narrative Review of Mechanisms, Biomaterials, and Clinical Translation

by Kashia Goto, Daisuke Watanabe, Kazuki Yanagida, Tatsuya Takagi and Akio Mizushima

Cancers 2025, 17(15), 2438; https://doi.org/10.3390/cancers17152438 - 23 Jul 2025

Cited by 2 | Viewed by 1614

Abstract

We present a narrative review focusing on the therapeutic potential of mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) in regenerating bone defects, particularly those resulting from surgical treatment of malignant bone and soft tissue tumors. These large bone defects pose significant challenges for reconstruction and functional recovery, highlighting the need for innovative regenerative strategies. Background: MSCs, which can differentiate into various cell types, are known for their immunosuppressive properties and ability to promote tissue repair. MSC-EVs, rich in bioactive molecules like microRNAs and proteins, play a crucial role in bone regeneration by mediating intercellular communication and modulating inflammation. Methods: This narrative review compiles data from various studies, including systematic reviews and individual research, focusing on the application of MSC-EVs in bone defect treatment. It examines the characteristics, mechanisms of action, and therapeutic effects of MSC-EVs, as well as the microRNAs involved in bone regeneration. Results: The findings indicate that MSC-EVs can enhance both osteogenesis and angiogenesis, highlighting their potential as promising candidates for clinical applications in bone defects. However, many mechanisms remain unclear; therefore, further investigation is needed. Conclusions: The review emphasizes the potential of MSC-EVs in improving patient outcomes for severe bone defects. It also highlights future challenges, including formulation, standardization, safety, and delivery methods, particularly in conjunction with biomaterials. Overall, MSC-EVs represent a significant advancement in regenerative medicine for bone defects. Full article

(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))

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