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Updated: Aug 17, 2025
Three-Dimensional Bone Extracellular Matrix Model for Osteosarcoma
Published on: April 12, 2019
Expression and Clinical Significance of Various Checkpoint Molecules in Advanced Osteosarcoma: Possibilities for
Lu Xie1, Chenglong Chen1, Xin Liang1
1Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, China.
Objectives:
The fact that studies on anti-programmed cell death 1 (PD-1) or its relevant ligand 1 (PD-L1) have yielded such few responses greatly decreases the confidence in immunotherapy with checkpoint inhibitors for advanced osteosarcoma. We intended to characterize the expression of various checkpoint molecules with immunohistochemistry in osteosarcoma specimens and analyzed the relationship of the expression of these checkpoint molecules with patients' clinical courses.
Methods:
This study was a retrospective non-intervention study from August 1st 2017 to March 1st 2020. Immunohistochemistry for B7-H3 (CD276, Cluster of Differentiation 276), CD47 (Cluster of Differentiation 47), PD-L1 (programmed cell death ligand 1), TIM3 (mucin-domain containing-3), TGF-β (TransformingGrowth Factor β), CXCR 4 (Chemokine Receptor 4), CD27 (Cluster of Differentiation 27), IDO1 (Indoleamine 2,3-dioxygenase 1), KIRs (Killer cell Immunoglobulin-like Receptors), and SDF-1 (Stromal cell-Derived Factor-1) was performed on 35 resected osteosarcoma specimens. Patients progressed upon first-line chemotherapy with evaluable lesions were qualified for this study, and their specimens previously stored in the pathological department repository would be retrieved for analysis. Associations between the immunohischemistry markers and clinicopathological variables and survival were evaluated by the χ2 displayed by cross-table, Cox proportional hazards regression model, and Kaplan-Meier plots.
Results:
The positive rates of B7-H3, CD47, PD-L1, TIM3, and TGF-β expression in this sample of 35 heavily treated osteosarcomas were 29% (10/35), 15% (5/35), 9% (3/35), 6% (2/35), and 6% (2/35), respectively, and diverse staining intensities were observed. Among these advanced patients, 15/35 (43%) had positive checkpoint expression, of which 33% (5/15) showed evidence of the co-expression of more than one checkpoint molecule. We did not find any obvious correlation with clinicopathological characteristics and the positive expression of these molecules.
Conclusions:
The present study highlights that only a small subset of progressive osteosarcomas, which had been heavily-treated, expressed tumor immune-associated checkpoint molecules, of which B7-H3 was the most positively expressed checkpoint and might be a promising target for further osteosarcoma investigation.
Insights
Immunotherapy for advanced osteosarcoma shows limited response. This study found B7-H3 as the most expressed immune checkpoint in heavily treated osteosarcoma, suggesting it as a potential therapeutic target.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Immunotherapy, particularly with checkpoint inhibitors targeting programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1), has shown limited efficacy in advanced osteosarcoma.
- Understanding the expression of various immune checkpoint molecules is crucial for developing effective therapeutic strategies.
Purpose of the Study:
- To investigate the expression of multiple immune checkpoint molecules in osteosarcoma specimens.
- To analyze the correlation between checkpoint molecule expression and patient clinical outcomes in advanced osteosarcoma.
Main Methods:
- A retrospective analysis of 35 resected osteosarcoma specimens from patients who progressed on first-line chemotherapy.
- Immunohistochemistry was performed to assess the expression of B7-H3, CD47, PD-L1, TIM3, TGF-β, and other checkpoint-related molecules.
- Statistical analyses, including Chi-squared tests, Cox regression, and Kaplan-Meier plots, were used to evaluate associations with clinicopathological variables and survival.
Main Results:
- Positive expression rates for B7-H3, CD47, PD-L1, TIM3, and TGF-β were 29%, 15%, 9%, 6%, and 6%, respectively.
- Overall, 43% of advanced osteosarcoma patients exhibited positive expression of at least one checkpoint molecule, with 33% showing co-expression.
- No significant correlation was found between the expression of these checkpoint molecules and clinicopathological characteristics.
Conclusions:
- A small subset of heavily treated, progressive osteosarcomas express tumor immune-associated checkpoint molecules.
- B7-H3 was the most frequently expressed checkpoint molecule, indicating its potential as a promising therapeutic target for osteosarcoma.
- Further investigation into B7-H3 as a target for osteosarcoma immunotherapy is warranted.
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