The heterogeneity and drug resistance of malignant cells and intercellular communication of microenvironment in osteosarcoma: Based on single‐cell analysis

Abstract Background Osteosarcoma (OS) is a prevalent bone cancer characterized by its aggressive nature, which often metastasizes to the lungs and contributes to a poor prognosis. Treatment progress has been hindered by drug resistance, distant metastases, and significant patient heterogeneity. However, recent advancements in technologies such as sequencing and multi‐omics have enabled more in‐depth investigations at the micro level. Aim By undertaking a critical analysis of related studies, the present work intends to provide an overview of the microenvironmental features of osteosarcoma discovered through single‐cell RNA sequencing (scRNA‐seq) analysis. The articles included in this review were from several medical and health databases. Results and discussion We also discuss drug resistance traits, taking into account the heterogeneity of OS cells within the tumor microenvironment (TME). This includes inherent and acquired resistance in both pre‐ and post‐chemotherapy osteosarcoma, as well as the close association between cancer stem cells (CSCs) and drug resistance. Additionally, we examine the intercellular communication between OS cells and other cell types, as revealed by both traditional and single‐cell studies, and suggest several promising therapeutic targets. Conclusion Single‐cell RNA sequencing (scRNA‐seq) provides a detailed view of the tumor microenvironment, revealing intercellular communication between osteosarcoma cells and other cells, and aiding in the identification of potential therapeutic targets.