Arakil Nour, Akhund Shahid Akhtar, Elaasser Basant, Mohammad Khalid S
Department of Anatomy, College of Medicine, Alfaisal University, Riyadh 1153, Saudi Arabia.
Biomedicines. 2024 May 13;12(5):1075. doi: 10.3390/biomedicines12051075.
The phenomenon of bone metastases presents a significant challenge within the context of advanced cancer treatments, particularly pertaining to breast, prostate, and lung cancers. These metastatic occurrences stem from the dissemination of cancerous cells into the bone, thereby interrupting the equilibrium between osteoblasts and osteoclasts. Such disruption results in skeletal complications, adversely affecting patient morbidity and quality of life. This review discusses the intricate interplay between cancer cells and the bone microenvironment, positing the bone not merely as a passive recipient of metastatic cells but as an active contributor to cancer progression through its distinctive biochemical and cellular makeup. A thorough examination of bone structure and the dynamics of bone remodeling is undertaken, elucidating how metastatic cancer cells exploit these processes. This review explores the genetic and molecular pathways that underpin the onset and development of bone metastases. Particular emphasis is placed on the roles of cytokines and growth factors in facilitating osteoclastogenesis and influencing osteoblast activity. Additionally, this paper offers a meticulous critique of current diagnostic methodologies, ranging from conventional radiography to advanced molecular imaging techniques, and discusses the implications of a nuanced understanding of bone metastasis biology for therapeutic intervention. This includes the development of targeted therapies and strategies for managing bone pain and other skeletal-related events. Moreover, this review underscores the imperative of ongoing research efforts aimed at identifying novel therapeutic targets and refining management approaches for bone metastases. It advocates for a multidisciplinary strategy that integrates advancements in medical oncology and radiology with insights derived from molecular biology and genetics, to enhance prognostic outcomes and the quality of life for patients afflicted by this debilitating condition. In summary, bone metastases constitute a complex issue that demands a comprehensive and informed approach to treatment. This article contributes to the ongoing discourse by consolidating existing knowledge and identifying avenues for future investigation, with the overarching objective of ameliorating patient care in the domain of oncology.
在晚期癌症治疗领域,骨转移现象构成了一项重大挑战,尤其是对于乳腺癌、前列腺癌和肺癌而言。这些转移事件源于癌细胞扩散至骨骼,从而打破了成骨细胞与破骨细胞之间的平衡。这种失衡会引发骨骼并发症,对患者的发病率和生活质量产生不利影响。本综述探讨了癌细胞与骨微环境之间的复杂相互作用,认为骨骼不仅是转移细胞的被动接纳者,而且通过其独特的生化和细胞组成,积极促进癌症进展。我们对骨骼结构和骨重塑动力学进行了全面研究,阐明了转移性癌细胞如何利用这些过程。本综述探索了支撑骨转移发生和发展的遗传和分子途径。特别强调了细胞因子和生长因子在促进破骨细胞生成以及影响成骨细胞活性方面的作用。此外,本文对当前的诊断方法进行了细致批判,从传统放射摄影到先进的分子成像技术,并讨论了对骨转移生物学的细微理解对治疗干预的影响。这包括靶向治疗的开发以及处理骨痛和其他骨骼相关事件的策略。此外,本综述强调了持续研究工作的必要性,旨在确定骨转移的新型治疗靶点并完善管理方法。它提倡采用多学科策略,将医学肿瘤学和放射学的进展与分子生物学和遗传学的见解相结合,以提高预后效果并改善患有这种使人衰弱疾病的患者的生活质量。总之,骨转移是一个复杂问题,需要全面且明智的治疗方法。本文通过整合现有知识并确定未来研究途径,为正在进行的讨论做出了贡献,其总体目标是改善肿瘤学领域的患者护理。
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