Prevention of Bone Metastases pp 109-126

Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 192) | Cite as

Bisphosphonates: Prevention of Bone Metastases in Prostate Cancer

Chapter

Abstract

Bone metastases and their associated morbidities are common in patients with advanced prostate cancer and other genitourinary (GU) malignancies. Zoledronic acid> (a bisphosphonate) has long been the mainstay of treatment for reducing the risk of skeletal-related events in patients with bone metastases from GU cancers, and denosumab (a monoclonal antibody directed against the receptor activator of nuclear factor kappa B ligand [RANKL]) has recently received approval for this indication in the United States. Preclinical data indicate that modifying the bone microenvironment may render it less conducive to metastasis, and emerging clinical findings suggest that the potential benefits from bone-directed therapies are not limited to reducing skeletal morbidity—these agents might help to improve survival and delay bone disease progression or even development of bone metastases (if used earlier in the disease course). This chapter reviews the rationale and recent clinical data supporting an antimetastatic role for bone-directed therapies in patients with GU malignancies.

Keywords

Anticancer Bisphosphonate Bone metastases Genitourinary cancer>  Prostate cancer Zoledronic acid>  

Abbreviations

ADT

Androgen-deprivation therapy

BALP

Bone-specific alkaline phosphatase

BMD

Bone mineral density

BP

Bisphosphonate

CRPC

Castration-resistant prostate cancer

CTC

Circulating tumor cell

DM

Distant metastasis

DTC

Disseminated tumor cell

E-E

Patients with elevated baseline and 3-month NTX

E-N

Patients with elevated baseline and normalized 3-month NTX

γδ

Gamma-delta (T cells)

GU

Genitourinary

HR

Hazard ratio

MM

Multiple myeloma

N-BP

Nitrogen-containing bisphosphonate

NTX

N-telopeptide of type I collagen

OS

Overall survival

PC

Prostate cancer

PO

Oral(ly)

PSA

Prostate-specific antigen

RANKL

Receptor activator of nuclear factor kappa B ligand

RCC

Renal cell carcinoma

RP

Radical prostatectomy

SC

Subcutaneous(ly)

SRE

Skeletal-related event

ZOL

Zoledronic acid

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Centre Hospitalier de l’Université de Montréal, Hôpital Notre-DameMontréalCanada

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