Decoding the function of cancer-associated fibroblasts in osteosarcoma: Molecular pathways, therapeutic approaches and prognostic significance.

Herein, we summarize the latest insights into osteosarcoma, the most prevalent primary malignant bone tumor, known for its aggressive nature, poor outcome, and especially poor prognosis when metastasis develops. Given recent research implicating the crucial role of the tumor microenvironment (TME) in osteosarcoma progression, cancer-associated fibroblasts (CAFs) emerged as key players. Through the secretion of cytokines, remodeling of the extracellular matrix (ECM), and cross-talk with osteosarcoma cells, CAFs collectively promote tumor growth, metastasis, and immune evasion.