Saad Fred, Lattouf Jean-Baptiste
Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada.
Recent Results Cancer Res. 2012;192:109-26. doi: 10.1007/978-3-642-21892-7_5.
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.
骨转移及其相关并发症在晚期前列腺癌和其他泌尿生殖系统（GU）恶性肿瘤患者中很常见。唑来膦酸（一种双膦酸盐）长期以来一直是降低GU癌症骨转移患者发生骨相关事件风险的主要治疗药物，而地诺单抗（一种针对核因子κB受体活化因子配体[RANKL]的单克隆抗体）最近在美国已获批用于该适应症。临床前数据表明，改变骨微环境可能使其不利于转移，新出现的临床研究结果表明，骨靶向治疗的潜在益处不仅限于降低骨病发病率——这些药物可能有助于提高生存率、延缓骨病进展，甚至延缓骨转移的发生（如果在疾病进程中更早使用）。本章回顾了支持骨靶向治疗在GU恶性肿瘤患者中发挥抗转移作用的理论依据和最新临床数据。
