Department of Gynecology, Philipps-University of Marburg, Marburg, Germany.
Crit Rev Oncol Hematol. 2013 Aug;87(2):101-11. doi: 10.1016/j.critrevonc.2013.05.015. Epub 2013 Jul 6.
Patients with breast cancer face substantial challenges to bone health from bone metastases, as well as from chemotherapy and endocrine therapies that generally elicit disease control at the cost of increased bone turnover. Consequently, maintaining bone health is of critical importance for these patients. Recently reported results from BOLERO-2 showed significant clinical benefits with adding everolimus to exemestane therapy in postmenopausal women with estrogen-receptor-positive breast cancer recurring or progressing despite nonsteroidal aromatase inhibitor therapy. Moreover, exploratory analyses from BOLERO-2 showed that adding everolimus may have beneficial effects on bone turnover and progressive disease in bone in this patient population. These results are supported by preclinical studies in which mTOR inhibition was associated with decreased osteoclast survival and activity. Thus, everolimus therapy may be able to ameliorate the negative effects of estrogen suppression on bone health. This review discusses the effects of mTOR inhibition on bone health during endocrine therapy.
乳腺癌患者面临着来自骨转移、化疗和内分泌治疗的巨大骨骼健康挑战，这些治疗通常以增加骨转换为代价来控制疾病。因此，维持骨骼健康对这些患者至关重要。最近的 BOLERO-2 研究结果显示，对于接受非甾体芳香酶抑制剂治疗后复发或进展的雌激素受体阳性乳腺癌绝经后妇女，添加依维莫司至依西美坦治疗具有显著的临床获益。此外，来自 BOLERO-2 的探索性分析显示，在这一患者人群中，添加依维莫司可能对骨骼转换和骨骼进展性疾病有有益影响。这些结果得到了临床前研究的支持，其中 mTOR 抑制与破骨细胞存活和活性降低有关。因此，依维莫司治疗可能能够减轻雌激素抑制对骨骼健康的负面影响。这篇综述讨论了 mTOR 抑制在内分泌治疗期间对骨骼健康的影响。
