Novel approaches to the management of bone metastases.
Standard management of breast cancer metastatic to bone includes systemic chemotherapy and, if applicable, hormone therapy, as well as radiotherapy for control of pain or prevention of pathologic fractures. In addition, orthopedic surgical procedures are used to prevent or correct pathologic fractures in weight-bearing areas of the osseous skeleton. Inhibitors of osteoclast function, including bisphosphonates and gallium nitrate, have been shown in clinical trials to decrease bone-related complications. Consequently, bisphosphonates have become an integral part of the management of bone metastases from breast cancer. Improved understanding of the biology of osteoclastogenesis led to the identification of osteoprotegerin as a critical modulator of osteoclast activity. The clinical evaluation of several osteoprotegerin preparations has shown therapeutic effects as measured by significant reductions in biochemical markers of bone resorption. Monoclonal antibodies to RANK ligand and parathyroid hormone-related protein, as well as Src kinase inhibitors, are also currently under clinical evaluation.
Hortobagyi
Gabriel N
GN
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77303-4009, USA.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy*; D001862:Bone Resorption; D001943:Breast Neoplasms / Q000473:pathology; D002352:Carrier Proteins; D016207:Cytokines; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006023:Glycoproteins / Q000037:antagonists & inhibitors; D006801:Humans; D008024:Ligands; D008562:Membrane Glycoproteins; D010010:Osteoclasts / Q000187:drug effects*; D053244:Osteoprotegerin; D053245:RANK Ligand; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D053246:Receptor Activator of Nuclear Factor-kappa B; D044168:Receptor, Parathyroid Hormone, Type 1; D018160:Receptors, Cytoplasmic and Nuclear / Q000037:antagonists & inhibitors; D018124:Receptors, Tumor Necrosis Factor; D015398:Signal Transduction; D019061:src-Family Kinases / Q000037:antagonists & inhibitors
D000970:Antineoplastic Agents; D002352:Carrier Proteins; D016207:Cytokines; D004791:Enzyme Inhibitors; D006023:Glycoproteins; D008024:Ligands; D008562:Membrane Glycoproteins; D053244:Osteoprotegerin; D053245:RANK Ligand; D019275:Radiopharmaceuticals; D053246:Receptor Activator of Nuclear Factor-kappa B; D044168:Receptor, Parathyroid Hormone, Type 1; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C505686:TNFRSF11A protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; D019061:src-Family Kinases