Oncology Division, Hospital de Santa Maria - CHLN, Lisbon, Portugal.
Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
Br J Clin Pharmacol. 2019 Jun;85(6):1114-1124. doi: 10.1111/bcp.13852. Epub 2019 Feb 16.
Bone disease is a frequent event in cancer patients, both due to cancer spread to bone and to cancer therapies. Bone is the organ most frequently affected by metastatic disease when considering the two most frequent cancers in the Western world (breast and prostate cancers). Bone metastases can have a substantial detrimental effect on patients' quality of life, as well as significant morbidity due to complications collectively known as skeletal-related events (SREs), which include hypercalcaemia, pathological fractures, spinal cord compression, and need of radiotherapy or surgery to the bone. These have been successfully mitigated with the development of bone-targeted agents (BTAs; bisphosphonates and denosumab), focused on inhibiting osteoclast activity. The potential direct antitumour effect of bisphosphonates, as well as the impact of osteoclast inhibition with subsequent decrease in bone metabolism, have also propelled investigation on the role of BTAs in preventing cancer relapse in bone. In this review, the authors aimed to discuss the role of BTAs in the treatment and prevention of bone metastases, as well as their potential value in preventing cancer treatment-induced bone loss (CTIBL). The review will focus on breast and prostate cancers, with the aim of providing the most relevant clinical data emerging from bench to bedside translational research in the field of cancer-induced bone disease.
骨病是癌症患者常见的病症，这既与癌症向骨骼转移有关，也与癌症治疗相关。在考虑西方世界最常见的两种癌症（乳腺癌和前列腺癌）时，骨骼是转移性疾病最常累及的器官。骨转移会对患者的生活质量产生实质性的负面影响，并且由于骨骼相关事件（SREs）的并发症，包括高钙血症、病理性骨折、脊髓压迫以及需要对骨骼进行放射治疗或手术，也会显著增加发病率。随着骨靶向药物（BTAs；双磷酸盐和地舒单抗）的发展，这些问题得到了成功缓解，这些药物主要针对抑制破骨细胞的活性。双磷酸盐的潜在直接抗肿瘤作用，以及破骨细胞抑制后骨代谢减少的影响，也推动了对 BTAs 在预防骨转移复发中的作用的研究。在这篇综述中，作者旨在讨论 BTAs 在治疗和预防骨转移以及预防癌症治疗引起的骨丢失（CTIBL）中的作用。该综述将重点关注乳腺癌和前列腺癌，旨在提供该领域从基础研究到临床转化研究中出现的最相关的临床数据。
