Milton S. Hershey Medical Center, Penn State University, Hershey, PA, USA.
Semin Oncol. 2010 Oct;37 Suppl 2:S15-29. doi: 10.1053/j.seminoncol.2010.10.002.
Several cancers, including those originating in the breast, prostate, and lung, exhibit a propensity to metastasize to bone, resulting in debilitating skeletal complications. These sequelae, such as intractable pain, pathologic fractures, spinal compression, and hypercalcemia, greatly erode the patients' quality of life. Bisphosphonates, a class of antiresorptive drugs, are now the mainstay of the treatment of skeletal-related events in myeloma bone disease and many solid cancers with bone metastases. Current evidence indicates that newer-generation nitrogen-containing bisphosphonates, particularly zoledronic acid, are potent inhibitors of bone resorption. In addition, increased understanding of the pathogenesis of bone metastasis has resulted in the development of several bone-targeted therapies including a monoclonal antibody targeting the receptor activator of nuclear factor (NF)-κB ligand (RANKL). In this review, clinical evidence regarding the efficacy and safety of currently available bone-targeted therapies including bisphosphonates and anti-RANKL monoclonal antibody in the treatment of bone metastasis due to breast cancer, prostate cancer, lung cancer, and multiple myeloma bone disease will be summarized.
几种癌症，包括乳腺癌、前列腺癌和肺癌，都有向骨骼转移的倾向，导致骨骼并发症，使患者身体虚弱。这些后遗症，如难以忍受的疼痛、病理性骨折、脊柱压缩和高钙血症，极大地降低了患者的生活质量。双膦酸盐类药物是一类抗吸收药物，目前是骨髓瘤骨病和许多有骨转移的实体瘤中骨骼相关事件治疗的主要方法。目前的证据表明，新一代含氮双膦酸盐类药物，特别是唑来膦酸，是骨吸收的有效抑制剂。此外，对骨转移发病机制的深入了解导致了几种骨靶向治疗方法的发展，包括针对核因子（NF）-κB 配体（RANKL）受体激活剂的单克隆抗体。在这篇综述中，将总结目前可用于治疗乳腺癌、前列腺癌、肺癌和多发性骨髓瘤骨病引起的骨转移的骨靶向治疗方法（包括双膦酸盐类药物和抗 RANKL 单克隆抗体）的疗效和安全性的临床证据。
