Advances in the association between tumor immune microenvironment remodeling in osteosarcoma and the risk of pathological fractures.

Immunosuppressive tumor microenvironment remodeling in osteosarcoma increases pathological fracture risk by disrupting bone metabolism, with a significant impact on prognosis.

• Why it matters: Understanding how immune cell changes influence bone destruction is crucial because pathological fractures worsen patient outcomes and are a major complication in osteosarcoma management.
• What they did: The study reviews cellular and molecular interactions within the tumor immune microenvironment, including macrophage polarization, T cell regulation, and cytokine networks, supported by in vitro and xenograft evidence.
• The result: Targeting immune components and cytokine pathways offers potential for therapies that reduce fracture risk and improve treatment precision, guiding future multimodal osteosarcoma interventions.