title: Denosumab for the management of bone disease in patients with solid tumors.
abstract: Many patients with advanced cancer develop bone metastases, which reduces their quality of life. Bone metastases are associated with an increased risk of skeletal-related events, which can lead to increased morbidity and mortality. In patients with bone metastases, tumor cells disrupt the normal process of bone remodeling, leading to increased bone destruction. Denosumab is a fully human monoclonal antibody against receptor activator of NF-κB ligand (RANKL), a key regulatory factor in bone remodeling. By binding to RANKL, denosumab disrupts the cycle of bone destruction. In clinical studies in patients with prostate or breast cancer and bone metastases, denosumab was superior to the current standard of care, zoledronic acid, for delaying skeletal-related events, while in patients with other solid tumors or multiple myeloma, denosumab was noninferior to zoledronic acid. This article examines the pharmacokinetics, efficacy, and safety and tolerability of denosumab for the management of bone events in patients with cancer.
authors.affiliation: Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, 4 Place Van Gehuchten, 1020 Brussels, Belgium. jean-jacques.body@chu-brugmann.be
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Body
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D061067:Antibodies, Monoclonal, Humanized; D001682:Biological Availability; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D001859:Bone Neoplasms / Q000378:metabolism / Q000473:pathology / Q000556:secondary / Q000628:therapy; D016723:Bone Remodeling / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D002986:Clinical Trials as Topic; D000069448:Denosumab; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D019468:Disease Management; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000379:methods*; D053245:RANK Ligand / Q000378:metabolism*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000378:metabolism; D000077211:Zoledronic Acid
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D007155:Immunologic Factors; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D000069448:Denosumab; D000077211:Zoledronic Acid