Sex differences in expression of immune elements emerge in children, young adults and mice with osteosarcoma

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


BACKGROUND: Males < 40 years old are more likely to be diagnosed with and die from osteosarcoma (OS). The underlying mechanisms may depend on sex differences in immune response.

METHODS: We used SEER data to estimate survival differences between males and females aged < 40 years at OS diagnosis. In NCI TARGET-OS cases, we determined sex differences in gene expression, conducted Gene Set Enrichment Analysis (GSEA), and applied the LM22 signature to identify biologic sex differences. We compared sex differences in gene expression profiles in TARGET-OS to those observed in Sleeping Beauty (SB) transposon mutagenesis accelerated Trp53 R270H-mutant mouse-OS and healthy adult osteoblasts.

RESULTS: Males had worse 17-year overall survival than females (SEER p < 0.0001). From 87 TARGET-OS cases, we observed 1018 genes and 69 pathways that differed significantly by sex (adjusted p < 0.05). Pathway and gene lists overlapped with those from mice (p = 0.03) and healthy osteoblasts (p = 0.017), respectively. Pathways that differed significantly by sex were largely immune-based and included the PD-1/PD-L1 immunotherapy pathway. We observed sex differences in M2 macrophages (LM22; p = 0.056) and M1-M2 macrophage transition (GSEA; p = 0.037) in TARGET-OS. LM22 trends were similar in mice. Twenty-four genes differentially expressed by sex in TARGET-OS had existing cancer therapies.

CONCLUSIONS: Sex differences in OS gene expression were similar across species and centered on immune pathways. Identified sex-specific therapeutic targets may improve outcomes in young individuals with OS.

Original languageEnglish (US)
Article number5
JournalBiology of Sex Differences
Issue number1
StatePublished - Dec 2021

Bibliographical note

Funding Information:
This work was supported by the Zach Sobiech Osteosarcoma Fund (LJM), the American Cancer Society Research Professorship (DAL), and the Children’s Cancer Research Fund (LAW).

Publisher Copyright:
© 2021, The Author(s).


  • Gene expression
  • Mouse osteosarcoma
  • Osteosarcoma
  • Pediatric and young adult cancer
  • Sex differences
  • Survival disparities


Dive into the research topics of 'Sex differences in expression of immune elements emerge in children, young adults and mice with osteosarcoma'. Together they form a unique fingerprint.

Cite this