Ishikawa Takashi
Tokyo Medical University, Department of Breast Oncology and Surgery, Japan.
Clin Calcium. 2018;28(11):1431-1440.
The bones are the most common organ where estrogen-receptor positive breast cancer tends to metastasize. Thus, it is important to treat and prevent bone metastases by studying pathogenesis of developing metastasis to the bones. As advancing treatments have significantly improved the quality of life in patients with bone metastases of breast cancer. Among them, bone-modifying agents have been playing the most crucial roles by reducing the rate of skeletal related events and also having a possibility of favorable effects on prognosis. Zoledronic-acid and denosumab are currently available and denosmab seems to be superior to zoledronic-acid in inhibiting osteoclastic activity. Although both of these are safe drugs, several rare but serious adverse events need to be cautious like osteonecrosis of the jaw, hypocalcemia, renal dysfunction and atypical fracture.
骨骼是雌激素受体阳性乳腺癌最常发生转移的器官。因此,通过研究乳腺癌向骨骼转移的发病机制来治疗和预防骨转移非常重要。随着治疗方法的不断进步,乳腺癌骨转移患者的生活质量得到了显著改善。其中,骨改良药物通过降低骨相关事件的发生率,对预后可能产生有利影响,发挥着最为关键的作用。唑来膦酸和地诺单抗目前均可使用,在抑制破骨细胞活性方面,地诺单抗似乎优于唑来膦酸。虽然这两种药物都是安全的,但仍需警惕一些罕见但严重的不良事件,如颌骨坏死、低钙血症、肾功能不全和非典型骨折。