Institute for Molecular Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
J Exp Clin Cancer Res. 2017 Aug 11;36(1):108. doi: 10.1186/s13046-017-0578-1.
Elucidation of mechanisms regulating bone metastasis has progressed significantly in recent years and this has translated to many new therapeutic options for patients with bone metastatic cancers. However, the rapid rate of progress in both the basic science literature and therapies undergoing clinical trials makes staying abreast with current developments challenging. This review seeks to provide an update on the current state of the science in bone metastasis research and give a snap shot of therapies in clinical trials for bone metastatic cancer.
Bone metastasis represents a difficult to treat clinical scenario due to pain, increased fracture risk, decreased quality of life and diminished overall survival outcomes. Multiple types of cancer have the specific ability to home to the bone microenvironment and cause metastatic lesions. This osteotropism was first described by Stephen Paget nearly 100 years ago as the 'seed and soil' hypothesis. Once cancer cells arrive at the bone they encounter a variety of cells native to the bone microenvironment which contribute to the establishment of bone metastatic lesions. In the first part of this review, the 'seed and soil' hypothesis is revisited while emphasizing recent developments in understanding the impact of native bone microenvironment cells on the metastatic process. Next, approved therapies for treating bone metastasis at the systemic level as well as those that target the bone microenvironment are discussed and current National Comprehensive Cancer Network (NCCN) guidelines relating to treatment of bone metastases are summarized. Finally, all open interventional clinical trials for therapies relating to treatment of bone metastasis have been complied and categorized.
Understanding the recent advancements in bone metastasis research is important for continued development of novel bone targeted therapies. The plethora of ongoing clinical trials will hopefully translate into improved treatments options for patients suffering from bone metastatic cancers.
近年来，阐明调节骨转移的机制取得了重大进展，这为骨转移癌症患者带来了许多新的治疗选择。然而，基础科学文献和临床试验中治疗方法的快速进展使得跟上当前的发展步伐具有挑战性。本综述旨在提供骨转移研究现状的最新更新，并介绍临床试验中用于治疗骨转移癌症的疗法。
骨转移是一种难以治疗的临床情况，其原因是疼痛、骨折风险增加、生活质量下降和总体生存结果降低。多种类型的癌症具有向骨微环境归巢并引起转移性病变的特定能力。这种亲骨性最初是由 Stephen Paget 在近 100 年前描述的，即“种子和土壤”假说。一旦癌细胞到达骨骼，它们就会遇到各种源自骨微环境的细胞，这些细胞有助于建立骨转移病变。在本综述的第一部分中，重新审视了“种子和土壤”假说，同时强调了理解固有骨微环境细胞对转移过程影响的最新进展。接下来，讨论了用于治疗全身性骨转移的已批准疗法以及针对骨微环境的疗法，并总结了与治疗骨转移相关的当前国家综合癌症网络 (NCCN) 指南。最后，编译并分类了所有与治疗骨转移相关的治疗干预临床试验。
了解骨转移研究的最新进展对于继续开发新型骨靶向疗法很重要。大量正在进行的临床试验有望为患有骨转移癌症的患者带来更好的治疗选择。
