Research advances in the role of osteoblasts and their derivatives in the development, recurrence, and distant metastasis of malignant bone tumors: a narrative review.

Malignant bone tumors, including primary bone tumors, such as osteosarcoma (OS), Ewing's sarcoma (ES), and multiple myeloma, and secondary bone tumors from prostate and breast cancers, pose significant mortality risks. Osteoblasts (OBs) and their derivatives play critical roles in the development, recurrence, and metastasis of these tumors. OBs promote metastasis-related events, including osteoclast differentiation and proliferation. Their derivatives, including extracellular vesicles and cytokines, modulate bone remodeling and tumor development through various signaling pathways. Recent in vivo and in vitro studies highlight the involvement of OBs in tumor progression, recurrence, and metastasis. Emerging therapies targeting OBs and their derivatives show promise in improving patient outcomes. The review emphasizes the importance of understanding the specific roles of OBs and their derivatives in malignant bone tumors. This knowledge can lead to the development of new therapeutic strategies aimed at improving patient survival rates and quality of life. Key findings include the regulatory effects of OBs on tumor dormancy, the vicious cycle of bone metastasis, and the potential for targeted therapies to disrupt these processes. Future research should focus on developing experimental models that more closely mimic the human tumor microenvironment and integrating multiple signaling pathways to create comprehensive treatment strategies.