Camacho Daniel F, Pienta Kenneth J
Department of Internal Medicine, University of Michigan Comprehensive Cancer Center, 7431 CCC 1500 E Medical Ctr, Ann Arbor, MI, 48109, USA.
Cancer Metastasis Rev. 2014 Sep;33(2-3):545-53. doi: 10.1007/s10555-013-9476-y.
The treatment of bone-metastatic cancer now takes advantage of the unique biology of this clinical state. The complex interplay between the cancer cells and the bone microenvironment leads to a host of therapeutic targets, with agents in various stages of clinical use or study. Targets include interactions between the cancer cells and osteoclasts, osteoblasts, endothelial cells, stromal cells, hematopoietic progenitor cells, cells of the immune system, and the bone matrix. Efforts at understanding specific mechanisms of drug resistance in the bone are also ongoing. Successful clinical outcomes will be the result of co-targeting and interrupting the various tumor-supportive elements and cooperating pathways at the level of the tumor cell, the primary and metastatic microenvironments, and systemic cancer effects, leading to a "scaled network disruption" to undermine the disease state.
目前，骨转移性癌的治疗利用了这种临床状态的独特生物学特性。癌细胞与骨微环境之间复杂的相互作用产生了许多治疗靶点，有处于临床应用或研究不同阶段的药物。靶点包括癌细胞与破骨细胞、成骨细胞、内皮细胞、基质细胞、造血祖细胞、免疫系统细胞以及骨基质之间的相互作用。对骨中耐药性具体机制的研究也在进行中。成功的临床结果将是在肿瘤细胞、原发和转移微环境以及全身癌症效应层面共同靶向并阻断各种肿瘤支持性元件和协同通路的结果，从而导致“规模化网络破坏”以削弱疾病状态。
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