Modulators of bone turn-over in the treatment of patients with bone metastases

Abstract

Bone metastases are a frequent complication of cancer, occurring in up to 70% of patients with advanced
breast or prostate cancer. Skeletal-related events involving pathological fractures, spinal cord compression
and a need for surgery/radiotherapy, which are frequently observed in cancer patients with bone
metastases have a detrimental effect on patients’ survival and quality of life. Therefore, prevention of
skeletal-related events is a crucial element in cancer treatment. The aim of this article was to summarize
data on approved bone-modifying agents used for treatment of cancer patients with bone metastases. In
breast cancer patients with bone metastases, several bisphosphonates and denosumab demonstrated
clinical efficacy, but in the case of bone metastases from prostate cancer or other solid tumors only zoledronic
acid and denosumab were clinically active. It is important to mention, that despite their significant
clinical efficacy neither bisphosphonates nor denosumab demonstrated any positive impact on survival
of patients with bone metastases.