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已发表论文
骨肉瘤纳米药物递送系统进展：从靶向策略到对抗肺转移
Authors Jia S, Gong B, Chen H , Chen Y, Zhuo C, Wu H, Qu X , Cai H
Received 3 December 2025
Accepted for publication 8 April 2026
Published 20 April 2026 Volume 2026:21 586319
DOI https://doi.org/10.2147/IJN.S586319
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Sachin Mali
Siyu Jia,1,2,* Boya Gong,3,* Haidan Chen,1,* Yaohui Chen,4 Can Zhuo,1 Hongyan Wu,5 Xingguang Qu,3 Huili Cai6
1Department of Spinal Surgery, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Yangtze River Delta Integration Demonstration Zone, Fudan University, Shanghai, 200000, People’s Republic of China; 3Department of Critical Care Medicine, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China; 4Department of Laboratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People’s Republic of China; 5College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China; 6Department of Hematology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Huili Cai, Department of Hematology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China, Email fjcaihuili@sina.com Haidan Chen, Department of Spinal Surgery, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China, Email wenquanchd@sina.com
Abstract: Osteosarcoma (OS) is the most prevalent primary malignant bone tumor in children and adolescents, characterized by aggressive local invasion, early distant metastasis (predominantly lung metastasis), and poor prognosis. Conventional clinical regimens, mainly neoadjuvant chemotherapy combined with surgical resection, are limited by severe systemic toxicity, multidrug resistance, low tumor targeting, and unsatisfactory outcomes for metastatic OS, with the 5-year survival rate of metastatic patients remaining below 30%. Nanodrug delivery systems (NDDS) have emerged as a transformative strategy to address these bottlenecks by enabling targeted drug/gene delivery, controlled release, enhanced tumor accumulation, and reduced off-target effects. This review systematically summarizes the pathological characteristics and therapeutic dilemmas of OS, highlights recent advances in diverse NDDS including lipid nanoparticles, polymeric nanoparticles, carbon-based nanomaterials, extracellular vesicles, gold nanoparticles, and hydrogels for OS therapy, with a special focus on strategies to counteract lung metastasis. We further discuss the clinical translation challenges of NDDS in OS, especially pediatric-specific concerns, and propose future directions such as stimuli-responsive nanocarriers, biomimetic nanoparticles, combination therapy, and inhalable nanomedicines for pulmonary metastatic lesions. Overall, NDDS hold great promise to revolutionize OS treatment by improving therapeutic efficacy and safety, particularly in overcoming lung metastasis and chemoresistance.
Keywords: osteosarcoma, nanodrug delivery system, targeted therapy, lung metastasis, pediatric cancer
1Department of Spinal Surgery, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Yangtze River Delta Integration Demonstration Zone, Fudan University, Shanghai, 200000, People’s Republic of China; 3Department of Critical Care Medicine, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China; 4Department of Laboratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People’s Republic of China; 5College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China; 6Department of Hematology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Huili Cai, Department of Hematology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China, Email fjcaihuili@sina.com Haidan Chen, Department of Spinal Surgery, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, Hubei, 443000, People’s Republic of China, Email wenquanchd@sina.com
Abstract: Osteosarcoma (OS) is the most prevalent primary malignant bone tumor in children and adolescents, characterized by aggressive local invasion, early distant metastasis (predominantly lung metastasis), and poor prognosis. Conventional clinical regimens, mainly neoadjuvant chemotherapy combined with surgical resection, are limited by severe systemic toxicity, multidrug resistance, low tumor targeting, and unsatisfactory outcomes for metastatic OS, with the 5-year survival rate of metastatic patients remaining below 30%. Nanodrug delivery systems (NDDS) have emerged as a transformative strategy to address these bottlenecks by enabling targeted drug/gene delivery, controlled release, enhanced tumor accumulation, and reduced off-target effects. This review systematically summarizes the pathological characteristics and therapeutic dilemmas of OS, highlights recent advances in diverse NDDS including lipid nanoparticles, polymeric nanoparticles, carbon-based nanomaterials, extracellular vesicles, gold nanoparticles, and hydrogels for OS therapy, with a special focus on strategies to counteract lung metastasis. We further discuss the clinical translation challenges of NDDS in OS, especially pediatric-specific concerns, and propose future directions such as stimuli-responsive nanocarriers, biomimetic nanoparticles, combination therapy, and inhalable nanomedicines for pulmonary metastatic lesions. Overall, NDDS hold great promise to revolutionize OS treatment by improving therapeutic efficacy and safety, particularly in overcoming lung metastasis and chemoresistance.
Keywords: osteosarcoma, nanodrug delivery system, targeted therapy, lung metastasis, pediatric cancer