Cheung Foon-Yiu
Hong Kong Integrated Oncology Centre, Central, Hong Kong.
Asia Pac J Clin Oncol. 2018 Nov;14 Suppl 5:13-15. doi: 10.1111/ajco.13061.
Bone metastases are a hallmark of advanced prostate cancer and may drive the morbidity and mortality of the disease in patients with a poor prognosis. The pathogenesis of bone metastasis involves the interaction between cancer cells, normal bone cells and the bone microenvironment. Targeting the bone microenvironment has become a promising therapy for patients with advanced prostate cancer and bone metastasis. This article reviews the use of the antiresorptive bone-targeted agents zoledronic acid and denosumab in the management of skeletal-related events (SREs) in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastasis. In real-world clinical practice, these agents have been widely prescribed as a concomitant medication to novel mCRPC therapies, such as abiraterone, enzalutamide and radium-223. International guidelines have recommended zoledronic acid or denosumab for the prevention of SREs in patients with bone metastasis from mCRPC. Although there is currently no consensus regarding the optimal sequencing between the bone-targeted agents and novel anti-cancer therapies, future optimal treatments for patients with bone metastasis from prostate cancer may involve the combination of these agents.
骨转移是晚期前列腺癌的一个标志，可能导致预后不良患者的疾病发病和死亡。骨转移的发病机制涉及癌细胞、正常骨细胞和骨微环境之间的相互作用。针对骨微环境已成为晚期前列腺癌和骨转移患者的一种有前景的治疗方法。本文综述了抗吸收骨靶向药物唑来膦酸和地诺单抗在转移性去势抵抗性前列腺癌（mCRPC）和骨转移患者骨骼相关事件（SREs）管理中的应用。在实际临床实践中，这些药物已被广泛作为伴随用药与新型mCRPC疗法（如阿比特龙、恩杂鲁胺和镭-223）联合使用。国际指南推荐唑来膦酸或地诺单抗用于预防mCRPC骨转移患者的SREs。尽管目前关于骨靶向药物与新型抗癌疗法之间的最佳序贯治疗尚无共识，但未来前列腺癌骨转移患者的最佳治疗可能涉及这些药物的联合应用。
