Clinical development of anti-RANKL therapies for treatment and prevention of bone metastasis.
The clinical sequelae from bone metastases, termed skeletal-related events, are among the most frequent and debilitating complications in patients with advanced cancer. Bone metastases are characterized by pathologically increased osteoclast activity, and accumulating evidence indicates that tumor cells interact within the bone to stimulate the RANK-RANK ligand (RANKL) pathway. RANKL is an essential mediator of osteoclast formation, function, and survival. Because of the central role of RANKL in cancer-induced bone destruction, the inhibition of RANKL has the potential to result in the reduction of pathologic bone resorption. Denosumab is a fully human monoclonal antibody specific for RANKL that inhibits the formation, activation, and survival of osteoclasts. This in turn decreases bone resorption and reduces cancer-induced bone destruction. As a result of its unique and specific mechanism of action, denosumab is being investigated for use in patients with advanced malignancies involving bone to prevent the occurrence of skeletal-related events.
Pennsylvania State University Milton S Hershey Medical Center, Hershey, PA, USA. alipton@psu.edu
Allan
A
Lipton
Carsten
C
Goessl
D000911:Antibodies, Monoclonal / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D019046:Bone Marrow Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control; D001859:Bone Neoplasms / Q000188:drug therapy / Q000517:prevention & control / Q000556:secondary; D001862:Bone Resorption / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D001842:Bone and Bones / Q000378:metabolism / Q000503:physiopathology; D002986:Clinical Trials as Topic; D000069448:Denosumab; D006801:Humans; D010010:Osteoclasts / Q000378:metabolism; D053245:RANK Ligand / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism* / Q000494:pharmacology / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053245:RANK Ligand; D000069448:Denosumab