Long-term benefits versus side-effects from bone-targeted therapies for cancer patients: minimizing risk while maximizing benefits.

PURPOSE OF REVIEW

Bone-targeted therapies such as bisphosphonates and denosumab are established in the treatment of cancer patients to prevent or delay skeletal-related events and improve quality of life. Along with these benefits of bone-targeted therapies, there are also known risks and adverse effects.

RECENT FINDINGS

Although historically bone-targeted therapy use has been limited to palliation in patients with bone metastases, recent evidence suggests that these agents may also have anti-cancer effects. This will likely lead to the greater use of these agents in patients with earlier-stage disease. Increased use will lead to more adverse effects. In particular, the risk of rare but severe toxicities will become important.

SUMMARY

This article explores strategies to maximize the clinical benefit of such therapy while minimizing associated risks.