Teissonnière Marie, Point Mathieu, Biver Emmanuel, Hadji Peyman, Bonnelye Edith, Ebeling Peter R, Kendler David, de Villiers Tobias, Holzer Gerold, Body Jean-Jacques, Fuleihan Ghada El Hajj, Brandi Maria Luisa, Rizzoli René, Confavreux Cyrille B
Pharmacie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
INSERM UMR1033-LYOS, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
Calcif Tissue Int. 2025 Mar 27;116(1):54. doi: 10.1007/s00223-025-01362-0.
Considerable progress has been made in the management of cancer patients in the last decade with the arrival of anti-cancer immunotherapies (immune checkpoint inhibitors) and targeted therapies. As a result, a broad spectrum of cancers, not just hormone-sensitive ones, have seen several patients achieve profound and prolonged remissions, or even cures. The management of medium- and long-term side-effects of treatment and quality of life of patients are essential considerations. This is especially true for bone, as bone fragility can lead to increased fractures and loss of autonomy, ultimately reducing the possibility of resuming physical activity. Physical activity is essential for lasting oncological remission and prevention of fatigue. While the issue of hormone therapies and their association with breast cancer has been recognized for some time, the situation is relatively new with regards to targeted therapies and immunotherapies. This is particularly challenging given the wide range of available targeted therapies and their application to numerous cancer types. This article provides a comprehensive review of the bone effects of the main anti-cancer therapies currently in use. The review goes beyond glucocorticoids and hormone therapies and discusses for each drug category what is known regarding cellular effects, BMD effects, and fracture incidence.
在过去十年中，随着抗癌免疫疗法（免疫检查点抑制剂）和靶向疗法的出现，癌症患者的管理取得了显著进展。因此，不仅是激素敏感型癌症，多种癌症都有不少患者实现了深度且持久的缓解，甚至治愈。治疗的中长期副作用管理以及患者的生活质量是至关重要的考量因素。对于骨骼来说尤其如此，因为骨质脆弱会导致骨折增加和自主能力丧失，最终降低恢复体力活动的可能性。体力活动对于持久的肿瘤缓解和预防疲劳至关重要。虽然激素疗法及其与乳腺癌的关联问题已被认识一段时间了，但靶向疗法和免疫疗法的情况相对较新。鉴于可用的靶向疗法种类繁多且应用于多种癌症类型，这尤其具有挑战性。本文全面综述了目前正在使用的主要抗癌疗法对骨骼的影响。该综述不仅涵盖糖皮质激素和激素疗法，还针对每种药物类别讨论了其已知的细胞效应、骨密度效应和骨折发生率。
