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Bisphosphonates: Prevention of Bone Metastases in Prostate Cancer

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Prevention of Bone Metastases

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

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.

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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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Acknowledgments

Financial support for medical editorial assistance was provided by Novartis Pharmaceuticals. We thank Shalini Murthy, PhD, ProEd Communications, Inc., for her medical editorial assistance with this manuscript.

Conflict of Interest

Dr. Saad has served as an advisor and conducted research for Novartis and Amgen and has received funding for medical editorial assistance from Novartis. Dr. Lattouf has served as a consultant for and received research funding from Novartis and Amgen.

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  1. Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Rue Sherbrooke East, Montréal, QC, Canada, H2L 4M

    Fred Saad & Jean-Baptiste Lattouf

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  1. Fred Saad
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Correspondence to Fred Saad .

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  1. , Dept. of Medical Oncology, Kantonsspital St. Gallen, Rorschacherstr. 95, St. Gallen, 9007, Switzerland

    Markus Joerger

  2. Chirurgische Klinik, Abt. Allgemeine Chirurgie, Universitätsklinikum Wien, Währinger Gürtel 18-20, Wien, 1090, Austria

    Michael Gnant

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Saad, F., Lattouf, JB. (2012). Bisphosphonates: Prevention of Bone Metastases in Prostate Cancer. In: Joerger, M., Gnant, M. (eds) Prevention of Bone Metastases. Recent Results in Cancer Research, vol 192. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-21892-7_5

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