AccScience Publishing / OR / Volume 2 / Issue 1 / DOI: 10.36922/OR026050004
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REVIEW ARTICLE

Toward precision oncology: Leveraging bone metastatic organoid models for mechanistic, translational, and therapeutic discovery

Chencong Lv1 ,  Xiao Chen2 ,  Hongjing Dou3 ,  Zhenping Cao4 ,  Jiacan Su2* ,  Tong Meng1*
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1 Department of Orthopedics, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2 Department of Orthopedics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
3 The State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
4 The State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
5 Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Institute of Molecular Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
OR 2026, 2(1), 026050004 https://doi.org/10.36922/OR026050004
Received: 28 January 2026 | Revised: 20 February 2026 | Accepted: 2 March 2026 | Published online: 26 March 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Bone metastasis represents a frequent late-stage complication in cancers such as lung, breast, and prostate, severely affecting patients’ quality of life. Conventional two‑dimensional cultures and animal models fail to recapitulate the complex bone microenvironment. Patient-derived organoids (PDOs) offer a physiologically relevant three-dimensional platform to recapitulate bone metastasis by preserving native tumor features and modeling tumor–bone interactions. This review systematically outlines the current methodologies for constructing bone metastatic organoid models, evaluates their applications, and identifies future directions. We describe the essential components of culture systems and critically discuss their strengths and limitations in modeling bone‑specific signaling. Furthermore, we highlight the capacity of PDOs to elucidate key aspects of bone metastasis, including tumor cell adaptation to the osseous niche, bidirectional remodeling of the microenvironment, and the dynamic monitoring of disease progression. Bone organoids are also discussed as a means of establishing a standardized bone microenvironment, offering a controllable in vitro platform for investigating interactions between tumor cells and the bone matrix. Furthermore, we present the translational potential of organoids for informing individualized therapy selection, evaluating clinical drug sensitivity, and facilitating the development of organoid biobanks. Looking forward, the development of patient-specific “bone metastasis-on-a-chip” systems with artificial intelligence-driven digital twins may transform the research paradigm from experimental simulation to precision prediction, ultimately advancing personalized therapeutic strategies for bone metastatic disease.

Keywords
Bone metastasis
Patient-derived organoids
Bone organoids
Tumor microenvironment
Precision medicine
Funding
This work was supported in part by the National Natural Science Foundation of China (grant numbers: 82522063, 82472786, 82173168).
Conflict of interest
The authors declare that they have no competing interests.
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