title: [Treatment of metastatic bone disease and treatment-induced osteoporosis in prostate cancer. Evolution of osteoprotective strategies].
abstract: Patients with prostate cancer and bone metastases on average experience one skeletal-related event per year. To avoid complications caused by bone metastases and androgen deprivation therapy-induced osteoporosis, which lead to significant increases in costs and mortality, bone metabolism can be influenced in several ways. Bisphosphonates, which directly inhibit signalling pathways in osteoclasts, can reduce the rate of skeletal-related events in metastatic prostate cancer. The RANKL antibody denosumab inhibits the crosstalk between osteoblasts, osteoclasts and tumour cells and has been shown to reduce the rate of vertebral fractures in patients with treatment-induced osteoporosis. Furthermore, it has been recently shown to prevent skeletal-related events in prostate cancer patients with metastatic bone disease. In patients with castration resistant prostate cancer, denosumab prolongs bone-metastasis-free-survival. Whereas ample data are available about side effects of bisphosphonates, limited evidence exists about the long-term safety profile of denosumab. Therefore, a thorough patient selection is advocated for therapeutic application of denosumab in patients with prostate cancer.
authors: Klinik für Urologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Deutschland. tilman.todenhoefer@med.uni-tuebingen.de
authors: T
authors: T
authors: Todenhöfer
authors: C
authors: C
authors: Schwentner
authors: D
authors: D
authors: Schilling
authors: G
authors: G
authors: Gakis
authors: A
authors: A
authors: Stenzl
mesh_terms: D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D000069448:Denosumab; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy / Q000401:mortality; D058866:Osteoporotic Fractures / Q000139:chemically induced / Q000517:prevention & control; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016103:Spinal Fractures / Q000139:chemically induced / Q000517:prevention & control; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000069448:Denosumab