van der Pluijm G, Vloedgraven H, van Beek E, van der Wee-Pals L, Löwik C, Papapoulos S
Department of Endocrinology and Metabolic Diseases, University Hospital, Leiden, The Netherlands.
J Clin Invest. 1996 Aug 1;98(3):698-705. doi: 10.1172/JCI118841.
Bisphosphonates are used with increasing frequency in the management of skeletal complications in patients with breast cancer. In this paper, we have investigated whether bisphosphonates, besides their known beneficial effects on tumor-associated osteoclastic resorption, are capable of inhibiting breast cancer cell adhesion to bone matrix. For that we used two in vitro models for bone matrix (cortical bone slices and cryostat sections of trabecular bone from neonatal mouse tails). Four bone matrix-bound nitrogen-containing bisphosphonates (pamidronate, olpadronate, alendronate, and ibandronate) inhibited adhesion and spreading of breast cancer cells to bone dose-dependently, whereas etidronate and clodronate had little or no effect. Strikingly, the relative order of potency of the bisphosphonates in inhibiting the adhesion of cancer cells to cortical and trabecular bone corresponded to their relative antiresorptive potencies in vivo as well as their ranking in in vitro bone resorption assays with predictive value for their clinical efficacy. It appears that nitrogen-containing bisphosphonates alter selectively the adhesive properties of the extracellular bone matrix preventing the attachment of breast cancer cells to it. Besides the beneficial effects of bisphosphonates on tumor-induced osteoclastic resorption, the previously unrecognized effect presented in this paper makes these agents suitable for earlier pharmacologic intervention in patients with breast cancer at risk of developing bone metastases.
双膦酸盐在乳腺癌患者骨骼并发症的治疗中应用频率越来越高。在本文中,我们研究了双膦酸盐除了对肿瘤相关破骨细胞吸收具有已知的有益作用外,是否还能够抑制乳腺癌细胞与骨基质的黏附。为此,我们使用了两种骨基质体外模型(新生小鼠尾巴的皮质骨切片和小梁骨低温切片)。四种与骨基质结合的含氮双膦酸盐(帕米膦酸、奥帕膦酸、阿仑膦酸和伊班膦酸)剂量依赖性地抑制乳腺癌细胞向骨的黏附和铺展,而依替膦酸和氯膦酸几乎没有作用或完全没有作用。令人惊讶的是,双膦酸盐在抑制癌细胞与皮质骨和小梁骨黏附方面的效力相对顺序,与其在体内的相对抗吸收效力以及在具有临床疗效预测价值的体外骨吸收试验中的排名相对应。似乎含氮双膦酸盐选择性地改变了细胞外骨基质的黏附特性,从而阻止乳腺癌细胞与之附着。除了双膦酸盐对肿瘤诱导的破骨细胞吸收的有益作用外,本文所呈现的此前未被认识到的作用使得这些药物适合于对有发生骨转移风险的乳腺癌患者进行早期药物干预。