University of Medical Sciences, Department of Dermatology, Poznan, Poland.
Expert Opin Investig Drugs. 2012 Jun;21(6):785-95. doi: 10.1517/13543784.2012.679928. Epub 2012 Apr 16.
Bone metastases are a frequent complication of cancer, occurring in up to 70% of patients with advanced breast or prostate cancer. Skeletal-related events involving pathological fractures, spinal cord compression and a need for surgery/radiotherapy, which are frequently observed in cancer patients with bone metastases have a detrimental effect on patients' survival and quality of life. Therefore, prevention of skeletal-related events is a crucial element in cancer treatment.
The aim of this article was to summarize data on bone-modifying agents used for treatment of cancer patients with bone metastases. We searched PubMed, EMBASE, and abstracts from ASCO, AUA, ESMO, AACR congresses for clinical studies evaluating bone-modulating agents in the treatment of patients with bone metastases.
In breast cancer patients with bone metastasis, several bisphosphonates and denosumab demonstrated clinical efficacy. On the other hand, in patients with bone metastases from prostate cancer or other solid tumors only zoledronic acid and denosumab were clinically active. However, neither bisphosphonates nor denosumab have any positive impact on survival of patients with bone metastases. In a recent interim analysis of a Phase III clinical study, a novel bone-modulating agent - radium-223 chloride (alpharadin), a bone-seeking alpha emitter, has been demonstrated to significantly improve median overall survival of prostate cancer patients with bone metastases compared with placebo.
骨转移是癌症的常见并发症，在晚期乳腺癌或前列腺癌患者中发生率高达 70%。骨骼相关事件，如病理性骨折、脊髓压迫和需要手术/放疗，在患有骨转移的癌症患者中经常观察到，这些事件对患者的生存和生活质量有不利影响。因此，预防骨骼相关事件是癌症治疗的关键要素。
本文旨在总结用于治疗骨转移癌症患者的骨修饰剂的数据。我们检索了 PubMed、EMBASE 以及 ASCO、AUA、ESMO、AACR 大会的摘要，以评估骨修饰剂在治疗骨转移患者中的临床研究。
在患有骨转移的乳腺癌患者中，几种双膦酸盐和地舒单抗显示出临床疗效。另一方面，在患有前列腺癌或其他实体瘤骨转移的患者中，只有唑来膦酸和地舒单抗具有临床活性。然而，双膦酸盐和地舒单抗都对骨转移患者的生存没有任何积极影响。在一项 III 期临床研究的中期分析中，一种新型骨修饰剂——镭-223 氯化物（阿法骨化醇），一种骨靶向的α发射体，与安慰剂相比，显著改善了前列腺癌骨转移患者的中位总生存期。
