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Castration-resistant prostate cancer with bone metastases: toward the best therapeutic choice

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Abstract

The treatment landscape for metastatic castration-resistant prostate cancer has evolved extremely in recent years and several drug classes are now available. Nonetheless, the lack of validated predictive biomarkers makes therapeutic choice and the best sequential approach difficult. The location of the metastatic site could be a valid criterion for choosing among the treatment options available. Although bone remains the most frequent metastatic site and a possible target for many drugs, recent data suggest a profound shift in the disease spectrum with visceral metastases increasing incidence. This review describes the presently available and ongoing therapies for patients with CRPC and bone metastases, focusing on the role of bone metastases as a possible driver for selecting therapies in these patients.

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References

  1. Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019;10(2):63–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. McCain J. Drugs that offer a survival advantage for men with bone metastases resulting from castration-resistant prostate cancer: New and emerging treatment options. Vol. 39, P and T. Medi Media USA Inc; 2014. p. 130.

  3. FDA approves olaparib for HRR gene-mutated metastatic castration-resistant prostate cancer. FDA [Internet] https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-olaparib-hrr-gene-mutated-metastatic-castration-resistant-prostate-cancer. Accessed 16 Oct 2021.

  4. Sartor O, de Bono J, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177–PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385(12):1091–103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Zustovich F, Fabiani F. Therapeutic opportunities for castration-resistant prostate cancer patients with bone metastases. Vol. 91, Critical Reviews in Oncology/Hematology. Elsevier Ireland Ltd; 2014; 197–209.

  6. Sathiakumar N, Delzell E, Morrisey MA, Falkson C, Yong M, Chia V, et al. Mortality following bone metastasis and skeletal-related events among men with prostate cancer: a population-based analysis of US Medicare beneficiaries, 1999–2006. Prostate Cancer Prostatic Dis. 2011;14(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  7. Rajpar S, Fizazi K. Bone targeted therapies in metastatic castration-resistant prostate cancer. Vol. 19, Cancer Journal (United States). Cancer J 2013;66–70.

  8. Pezaro CJ, Omlin A, Lorente D, Nava Rodrigues D, Ferraldeschi R, Bianchini D, et al. Visceral disease in castration-resistant prostate cancer. Eur Urol. 2014;65(2):270–3.

    Article  CAS  PubMed  Google Scholar 

  9. Doctor SM, Tsao CK, Godbold JH, Galsky MD, Oh WK. Is prostate cancer changing?: evolving patterns of metastatic castration-resistant prostate cancer. Cancer. 2014;120(6):833–9.

    Article  PubMed  Google Scholar 

  10. Scher HI, Halabi S, Tannock I, Morris M, Sternberg CN, Carducci MA, et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol. 2008;26:1148–59.

    Article  PubMed  Google Scholar 

  11. Scher HI. Building on prostate cancer working group 2 to change the paradigm from palliation to cure. Am Soc Clin Oncol Educ Book. 2014;34:e204–12.

    Article  Google Scholar 

  12. Halabi S, Lin CY, Kelly WK, Fizazi K, Moul JW, Kaplan EB, et al. Updated prognostic model for predicting overall survival in first-line chemotherapy for patients with metastatic castration-resistant prostate cancer. J Clin Oncol. 2014;32(7):671–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gandaglia G, Karakiewicz PI, Briganti A, Passoni NM, Schiffmann J, Trudeau V, et al. Impact of the site of metastases on survival in patients with metastatic prostate cancer. Eur Urol. 2015;68(2):325–34.

    Article  PubMed  Google Scholar 

  14. Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med. 2010;363(5):411–22.

    Article  CAS  PubMed  Google Scholar 

  15. Sequencing of agents for castration-resistant prostate cancer - PubMed [Internet]. https://pubmed.ncbi.nlm.nih.gov/24575543/. Accessed 16 Oct 2021.

  16. Small EJ, Higano CS, Kantoff PW, Whitmore JB, Frohlich MW, Petrylak DP. Time to disease-related pain and first opioid use in patients with metastatic castration-resistant prostate cancer treated with sipuleucel-T. Prostate Cancer Prostatic Dis. 2014;17(3):259–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Sonpavde G, Di Lorenzo G, Higano CS, Kantoff PW, Madan R, Shore ND. The role of sipuleucel-T in therapy for castration-resistant prostate cancer: A critical analysis of the literature. Vol. 61, European Urology. Elsevier; 2012. p. 639–47.

  18. Berthold DR, Pond GR, Soban F, De Wit R, Eisenberger M, Tannock IF. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: Updated survival in the TAX 327 study. J Clin Oncol. 2008;26(2):242–5.

    Article  CAS  PubMed  Google Scholar 

  19. Petrylak DP, Tangen CM, Hussain MHA, Lara PN, Jones JA, Taplin ME, et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med. 2004;351(15):1513–20.

    Article  CAS  PubMed  Google Scholar 

  20. Walsh PC. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. J Urol. 2011;185:2156–7.

    Article  Google Scholar 

  21. Bracarda S, Sisani M, Marrocolo F, Hamzaj A, Del Buono S, Altavilla A. Clinical implications for a treatment algorithm and differential indication to hormone therapy and chemotherapy options in metastatic castrate-resistant prostate cancer: a personal view. Exp Rev Anticancer Therapy. 2014;14:1283–94.

    Article  CAS  Google Scholar 

  22. Harrison MR, Wong TZ, Armstrong AJ, George DJ. Radium-223 chloride: a potential new treatment for castration-resistant prostate cancer patients with metastatic bone disease. Cancer Manag Res. 2013;5:1–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(5):424–33.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  24. de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011;364(21):1995–2005.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ryan CJ, Smith MR, de Bono JS, Molina A, Logothetis CJ, de Souza P, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013;368(2):138–48.

    Article  CAS  PubMed  Google Scholar 

  26. Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369(3):213–23.

    Article  CAS  PubMed  Google Scholar 

  27. Scher HI, Fizazi K, Saad F, Taplin M-E, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97.

    Article  CAS  PubMed  Google Scholar 

  28. Logothetis CJ, Basch E, Molina A, Fizazi K, North SA, Chi KN, et al. Effect of abiraterone acetate and prednisone compared with placebo and prednisone on pain control and skeletal-related events in patients with metastatic castration-resistant prostate cancer: exploratory analysis of data from the COU-AA-301 randomised trial. Lancet Oncol. 2012;13(12):1210–7.

    Article  CAS  PubMed  Google Scholar 

  29. So A, Chin J, Fleshner N, Saad F. Management of skeletal-related events in patients with advanced prostate cancer and bone metastases: Incorporating new agents into clinical practice. Can Urol Assoc J. 2012;6(6):465.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Effect of enzalutamide on health-related quality of life, pain, and skeletal-related events in asymptomatic and minimally symptomatic, chemotherapy-naive patients with metastatic castration-resistant prostate cancer (PREVAIL): results from a randomised, phase 3 trial - PubMed [Internet]. https://pubmed.ncbi.nlm.nih.gov/25888263/. Accessed 16 Oct 2021

  31. Sternberg CN, Saad F, Graff JN, Peer A, Vaishampayan UN, Leung E, et al. A randomised phase II trial of three dosing regimens of radium-223 in patients with bone metastatic castration-resistant prostate cancer. Ann Oncol. 2020;31(2):257–65.

    Article  CAS  PubMed  Google Scholar 

  32. Santini D, Cinieri S, Gasparro D, Bordonaro R, Guglielmini PF, Chiuri VE, et al. Effects of abiraterone acetate plus prednisone on bone turnover markers in chemotherapy-naïve mCRPC patients after ADT failure: a prospective analysis of the italian real-world study ABITUDE. J Bone Oncol. 2021;1:26.

    Google Scholar 

  33. Body JJ, von Moos R, Rider A, Hallworth P, Bhowmik D, Gatta F, et al. A real-world study assessing the use of bone-targeted agents and their impact on bone metastases in patients with prostate cancer treated in clinical practice in Europe. J Bone Oncol. 2019;1:14.

    Google Scholar 

  34. Jakob A, Zahn MO, Nusch A, Werner T, Schnell R, Frank M, et al. Real-world patient-reported outcomes of breast cancer or prostate cancer patients receiving antiresorptive therapy for bone metastases: final results of the PROBone registry study. J Bone Oncol. 2022;1(33): 100420.

    Article  Google Scholar 

  35. Saad F, Sternberg CN, Mulders PFA, Niepel D, Tombal BF. The role of bisphosphonates or denosumab in light of the availability of new therapies for prostate cancer. Cancer Treatment Rev. 2018;68:25–37.

    Article  CAS  Google Scholar 

  36. Saad F, Gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, et al. A Randomized, Placebo-Controlled Trial of Zoledronic Acid in Patients With Hormone-Refractory Metastatic Prostate Carcinoma. JNCI Journal of the National Cancer Institute. 2002;94(19):1458–68.

    Article  CAS  PubMed  Google Scholar 

  37. Fizazi K, Carducci M, Smith M, Damião R, Brown J, Karsh L, et al. Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomised, double-blind study. The Lancet. 2011;377(9768):813–22.

    Article  CAS  Google Scholar 

  38. Saad F, Shore N, Van Poppel H, Rathkopf DE, Smith MR, De Bono JS, et al. Impact of bone-targeted therapies in chemotherapy-naïve metastatic castration-resistant prostate cancer patients treated with abiraterone acetate: Post hoc analysis of study COU-AA-302. Eur Urol. 2015;68(4):570–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Smith M, Parker C, Saad F, Miller K, Tombal B, Ng QS, et al. Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer and bone metastases (ERA 223): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019;20(3):408–19.

    Article  CAS  PubMed  Google Scholar 

  40. Tombal BF, Loriot Y, Saad F, McDermott RS, Elliott T, Rodriguez-Vida A, et al. Decreased fracture rate by mandating bone-protecting agents in the EORTC 1333/PEACE III trial comparing enzalutamide and Ra223 versus enzalutamide alone: an interim safety analysis. J Clin Oncol. 2019;37(15):5007–5007.

    Article  Google Scholar 

  41. James N, Pirrie S, Pope A, Barton D, Andronis L, Goranitis I, et al. TRAPEZE: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of chemotherapy with zoledronic acid, strontium-89, or both, in men with bony metastatic castration-refractory prostate cancer. Health Technol Assess. 2016;20(53):1–127.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Broadwell A, Chines A, Ebeling PR, Franek E, Huang S, Smith S, et al. Denosumab safety and efficacy among participants in the FREEDOM extension study with mild to moderate chronic kidney disease. J Clin Endocrinol Metab. 2021;106(2):397–409.

    Article  PubMed  Google Scholar 

  43. Howell DD, James JL, Hartsell WF, Suntharalingam M, MacHtay M, Suh JH, et al. Single-fraction radiotherapy versus multifraction radiotherapy for palliation of painful vertebral bone metastases—Equivalent efficacy, less toxicity, more convenient: a subset analysis of radiation therapy oncology group trial 97–14. Cancer. 2013;119(4):888–96.

    Article  PubMed  Google Scholar 

  44. Harstell WF, Scott CB, Bruner DW, Scarantino CW, Ivker RA, Roach M, et al. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst. 2005;97(11):798–804.

    Article  Google Scholar 

  45. Tong D, Gillick L, Hendrickson FR. The palliation of symptomatic osseous metastases final results of the study by the radiation therapy oncology group. Cancer. 1982;50(5):893–9.

    Article  CAS  PubMed  Google Scholar 

  46. Chow E, Zeng L, Salvo N, Dennis K, Tsao M, Lutz S. Update on the systematic review of palliative radiotherapy trials for bone metastases. Clin Oncol. 2012;24(2):112–24.

    Article  CAS  Google Scholar 

  47. Husain ZA, Sahgal A, De Salles A, Funaro M, Glover J, Hayashi M, et al. Stereotactic body radiotherapy for de novo spinal metastases: systematic review international stereotactic radiosurgery society practice guidelines. J Neurosur. 2017;27:295–302.

    Google Scholar 

  48. Shulman RM, Meyer JE, Li T, Howell KJ. External beam radiation therapy (EBRT) for asymptomatic bone metastases in patients with solid tumors reduces the risk of skeletal-related events (SREs). Ann Palliat Med. 2019;8(2):159–67.

    Article  PubMed  Google Scholar 

  49. Berruti A, Generali D, Tampellini M. Enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(25):2448–9.

    Article  CAS  PubMed  Google Scholar 

  50. Oudard S, Banu E, Medioni J, Scotte F, Banu A, Levy E, et al. What is the real impact of bone pain on survival in patients with metastatic hormone-refractory prostate cancer treated with docetaxel? BJU Int. 2009;103(12):1641–6.

    Article  CAS  PubMed  Google Scholar 

  51. Hoskin P, Sartor O, O’Sullivan JM, Johannessen DC, Helle SI, Logue J, et al. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. Lancet Oncol. 2014;15(12):1397–406.

    Article  CAS  PubMed  Google Scholar 

  52. Halabi S, Vogelzang NJ, Kornblith AB, Ou SS, Kantoff PW, Dawson NA, et al. Pain predicts overall survival in men with metastatic castration-refractory prostate cancer. J Clin Oncol. 2008;26(15):2544–9.

    Article  PubMed  Google Scholar 

  53. Antonarakis ES, Lu C, Wang H, Luber B, Nakazawa M, Roeser JC, et al. AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer. N Engl J Med. 2014;371(11):1028–38.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Francini E, Petrioli R, Roviello G. No clear evidence of a clinical benefit of a sequential therapy regimen with abiraterone acetate and enzalutamide. Exp Rev Anticancer Therapy. 2014;14:1135–40.

    Article  CAS  Google Scholar 

  55. Roviello G, Petrioli R, Laera L, Francini E. The third line of treatment for metastatic prostate cancer patients: option or strategy? Crit Rev Oncol/Hematol. 2015;95:265–71.

    Article  Google Scholar 

  56. Antonarakis ES, Lu C, Luber B, Wang H, Chen Y, Nakazawa M, et al. Androgen receptor splice variant 7 and efficacy of taxane chemotherapy in patients with metastatic castration-resistant prostate cancer. JAMA Oncol. 2015;1(5):582–91.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Saad F, Carles J, Gillessen S, Heidenreich A, Heinrich D, Gratt J, et al. Radium-223 and concomitant therapies in patients with metastatic castration-resistant prostate cancer: an international, early access, open-label, single-arm phase 3b trial. Lancet Oncol. 2016;17(9):1306–16.

    Article  CAS  PubMed  Google Scholar 

  58. Armstrong AJ, Halabi S, Luo J, Nanus DM, Giannakakou P, Szmulewitz RZ, et al. The PROPHECY trial: Multicenter prospective trial of circulating tumor cell (CTC) AR-V7 detection in men with mCRPC receiving abiraterone (A) or enzalutamide (E). J Clin Oncol. 2018;36(15):5004–5004.

    Article  Google Scholar 

  59. Roviello G, Sigala S, Danesi R, del Re M, Bonetta A, Cappelletti MR, et al. Incidence and relative risk of adverse events of special interest in patients with castration resistant prostate cancer treated with CYP-17 inhibitors: a meta-analysis of published trials. Crit Rev Oncol/Hematol. 2016;101:12–20.

    Article  Google Scholar 

  60. Ojemuyiwa MA, Madan RA, Dahut WL. Tyrosine kinase inhibitors in the treatment of prostate cancer: taking the next step in clinical development. Exp Opin Emerg Drugs. 2014;19:459–70.

    Article  CAS  Google Scholar 

  61. Blair HC, Robinson LJ, Zaidi M. Osteoclast signalling pathways. Biochem Biophys Res Commun. 2005;328:728–38.

    Article  CAS  PubMed  Google Scholar 

  62. Wan X, Corn PG, Yang J, Palanisamy N, Starbuck MW, Efstathiou E, et al. Prostate cancer cell-stromal cell crosstalk via FGFR1 mediates antitumor activity of dovitinib in bone metastases. Science Translational Medicine. 2014;6(252).

  63. Araujo JC, Mathew P, Armstrong AJ, Braud EL, Posadas E, Lonberg M, et al. Dasatinib combined with docetaxel for castration-resistant prostate cancer: Results from a phase 1–2 study. Cancer. 2012;118(1):63–71.

    Article  CAS  PubMed  Google Scholar 

  64. Araujo JC, Trudel GC, Saad F, Armstrong AJ, Yu EY, Bellmunt J, et al. Docetaxel and dasatinib or placebo in men with metastatic castration-resistant prostate cancer (READY): a randomised, double-blind phase 3 trial. Lancet Oncol. 2013;14(13):1307–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Miyazaki T, Sanjay A, Neff L, Tanaka S, Horne WC, Baron R. Src kinase activity is essential for osteoclast function. J Biol Chem. 2004;279(17):17660–6.

    Article  CAS  PubMed  Google Scholar 

  66. Garcia-Gomez A, Ocio EM, Crusoe E, Santamaria C, Hernández-Campo P, Blanco JF, et al. Dasatinib as a bone-modifying agent: anabolic and anti-resorptive effects. PLoS ONE. 2012;7(4):e34914.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Smith M, De Bono J, Sternberg C, Moulec S Le, Oudard S, De Giorgi U, et al. Phase III study of cabozantinib in previously treated metastatic castration-resistant prostate cancer: COMET-1. J Clin Oncol. 2016;3005–3013.

  68. Smith DC, Smith MR, Sweeney C, Elfiky AA, Logothetis C, Corn PG, et al. Cabozantinib in patients with advanced prostate cancer: results of a phase II randomized discontinuation trial. J Clin Oncol. 2013;31(4):412–9.

    Article  CAS  PubMed  Google Scholar 

  69. Cabozantinib in chemotherapy-pretreated metastatic castration-resistant prostate cancer: Results of a phase II nonrandomized expansion study—Northwestern Scholars [Internet]. https://www.scholars.northwestern.edu/en/publications/cabozantinib-in-chemotherapy-pretreated-metastatic-castration-res. Accessed 16 Oct 2021

  70. EMA restricts use of prostate cancer medicine Xofigo | European Medicines Agency [Internet]. https://www.ema.europa.eu/en/news/ema-restricts-use-prostate-cancer-medicine-xofigo. Accessed 19 Apr 2022.

  71. Gillessen S, Choudhury A, Rodriguez-Vida A, Nole F, Gallardo Diaz E, Roumeguere TA, et al. Decreased fracture rate by mandating bone protecting agents in the EORTC 1333/PEACEIII trial combining Ra223 with enzalutamide versus enzalutamide alone: an updated safety analysis. J Clin Oncol. 2021;39(15_suppl):5002–5002.

    Article  Google Scholar 

  72. Radium-223 in combination with docetaxel in patients with castration-resistant prostate cancer and bone metastases: a phase 1 dose escalation/randomised phase 2a trial - PubMed [Internet]. https://pubmed.ncbi.nlm.nih.gov/31082669/. Accessed 16 Oct 2021.

  73. A Study to Test Radium-223 With Docetaxel in Patients With Prostate Cancer - Full Text View - ClinicalTrials.gov [Internet]. https://clinicaltrials.gov/ct2/show/NCT03574571. Accessed 17 Oct 2021.

  74. Kishi Y, Fujihara H, Kawaguchi K, Yamada H, Nakayama R, Yamamoto N, et al. PARP inhibitor PJ34 suppresses osteogenic differentiation in mouse mesenchymal stem cells by modulating BMP-2 signaling pathway. Int J Mol Sci. 2015;16(10):24820–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Shaya J, Xie W, Saraiya B, Parikh M, Folefac E, Olson AC, et al. A phase I/II study of combination olaparib and radium-223 in men with metastatic castration-resistant prostate cancer with bone metastases (COMRADE): a trial in progress. J Clin Oncol. 2021;39(6):TPS182–TPS182.

  76. de Bono J, Mateo J, Fizazi K, Saad F, Shore N, Sandhu S, et al. Olaparib for metastatic castration-resistant prostate cancer. N Engl J Med. 2020;382(22):2091–102.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy

    Giandomenico Roviello

  2. School of Human Health Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Martina Catalano, Carlotta Ottanelli & Roberta Giorgione

  3. Medical Oncology Unit, Careggi University Hospital, 50134, Florence, Italy

    Virginia Rossi, Elisabetta Gambale & Lorenzo Antonuzzo

  4. IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy

    Chiara Casadei & Ugo De Giorgi

  5. Department of Experimental and Clinical Medicine, University of Florence, 50134, Florence, Italy

    Lorenzo Antonuzzo

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  1. Giandomenico Roviello
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Study concept and design: RG. Acquisition of data: MC, VR, RB, RG, CO. Drafting of the manuscript: LA, UDG, CC. Critical revision of the manuscript for important intellectual content: LA. Obtaining funding: None. Administrative, technical, or material support: None. Supervision: LA. Financial disclosures: None. Funding/Support and role of the sponsor: None.

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Roviello, G., Catalano, M., Ottanelli, C. et al. Castration-resistant prostate cancer with bone metastases: toward the best therapeutic choice. Med Oncol 39, 145 (2022). https://doi.org/10.1007/s12032-022-01739-3

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