[Prostate cancer-related metastatic bone disease. Some new acquisitions about pathogenesis an therapeutic approaches].
Anatomic patterns of blood flow and specific dynamic interactions between prostate cancer cell and bone microenvironment influence the distribution of metastatic deposits. Bone components preferentially bind cancer cell and can facilitate tumor growth in bone; cancer cells, in turn, can release some factors that enhance osteoblastic activity. Recent studies, in animal models, have provided evidences of chemoattractant factors (bone homing factors) and of an enhanced adherence of prostate cancer cells to bone marrow endothelium. Additional data suggest "osteomimetic" pattern of prostate cancer cells after their arrival in bone, particularly by taking an osteoblastic behavior. The presence of the cancer cell in bone results in bone matrix increased turnover. Although prostate cancer is characterized by osteoblastic metastases, bone resorption is a regular feature of this tumor and is a necessary factor for its invasiveness in bone. Current treatment options based on radiotherapy and pharmacotherapy are essentially palliative. The bisphoshonates inhibit osteoclastic bone degradation by several mechanisms. Improved knowledges of the molecular mechanisms in the development of skeletal metastases allow to foresee biologically-based therapeutic strategies.
Alberti
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Clinica Urologica I, Dipartimento di Discipline Medico-Chirurgiche, Università degli Studi di Torino, Torino, Italy.
Tizzani
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D001859:Bone Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000556:secondary*; D016723:Bone Remodeling; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*