title: Metastasis and bone loss: advancing treatment and prevention.
abstract: Tumor metastasis to the skeleton affects over 400,000 individuals in the United States annually, more than any other site of metastasis, including significant proportions of patients with breast, prostate, lung and other solid tumors. Research on the bone microenvironment and its role in metastasis suggests a complex role in tumor growth. Parallel preclinical and clinical investigations into the role of adjuvant bone-targeted agents in preventing metastasis and avoiding cancer therapy-induced bone loss have recently reported exciting and intriguing results. A multidisciplinary consensus conference convened to review recent progress in basic and clinical research, assess gaps in current knowledge and prioritize recommendations to advance research over the next 5 years. The program addressed three topics: advancing understanding of metastasis prevention in the context of bone pathophysiology; developing therapeutic approaches to prevent metastasis and defining strategies to prevent cancer therapy-induced bone loss. Several priorities were identified: (1) further investigate the effects of bone-targeted therapies on tumor and immune cell interactions within the bone microenvironment; (2) utilize and further develop preclinical models to study combination therapies; (3) conduct clinical studies of bone-targeted therapies with radiation and chemotherapy across a range of solid tumors; (4) develop biomarkers to identify patients most likely to benefit from bone-targeted therapies; (5) educate physicians on bone loss and fracture risk; (6) define optimal endpoints and new measures of efficacy for future clinical trials; and (7) define the optimum type, dose and schedule of adjuvant bone-targeted therapy.
authors.affiliation: Yorkshire Cancer Research Professor of Medical Oncology, Academic Unit of Clinical Oncology, Weston Park Hospital, Whitham Road, Sheffield S102SJ, UK. r.e.coleman@sheffield.ac.uk
authors.forename: Robert E
authors.initials: RE
authors.lastname: Coleman
authors.forename: Allan
authors.initials: A
authors.lastname: Lipton
authors.forename: G David
authors.initials: GD
authors.lastname: Roodman
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Guise
authors.forename: Brendon F
authors.initials: BF
authors.lastname: Boyce
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brufsky
authors.forename: Philippe
authors.initials: P
authors.lastname: Clézardin
authors.forename: Peter I
authors.initials: PI
authors.lastname: Croucher
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Peyman
authors.initials: P
authors.lastname: Hadji
authors.forename: Ingunn
authors.initials: I
authors.lastname: Holen
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Mundy
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Smith
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Suva
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015519:Bone Density / Q000502:physiology; D001859:Bone Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D001862:Bone Resorption / Q000209:etiology / Q000517:prevention & control; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000517:prevention & control; D010024:Osteoporosis / Q000209:etiology / Q000517:prevention & control*; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D004164:Diphosphonates