title: Bone matters in lung cancer.
abstract: BACKGROUND
  Bone metastases are a significant and undertreated clinical problem in patients with advanced lung cancer.
  
  
  METHODS
  We reviewed the incidence of bone metastases and skeletal-related events (SREs) in patients with lung cancer and examined the burden on patients' lives and on health care systems. Available therapies to improve survival and lessen the impact of SREs on quality of life (QoL) were also investigated.
  
  
  RESULTS
  Bone metastases are common in lung cancer; however, owing to short survival times, data on the incidences of SREs are limited. As with other cancers, the costs associated with treating SREs in lung cancer are substantial. Bisphosphonates reduce the frequency of SREs and improve measures of pain and QoL in patients with lung cancer; however, nephrotoxicity is a common complication of therapy. Denosumab, a recently approved bone-targeted therapy, is superior to zoledronic acid in increasing the time to first on-study SRE in patients with solid tumours, including lung cancer. Additional roles of bone-targeted therapies beyond the prevention of SREs are under investigation.
  
  
  CONCLUSIONS
  With increasing awareness of the consequences of SREs, bone-targeted therapies may play a greater role in the management of patients with lung cancer, with the aim of delaying disease progression and preserving QoL.
authors.affiliation: Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna General Hospital, Vienna, Austria. Electronic address: thomas.brodowicz@meduniwien.ac.at.
authors.forename: T
authors.initials: T
authors.lastname: Brodowicz
authors.affiliation: HOPE Department, St James's Hospital, Dublin, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: O'Byrne
authors.affiliation: Interdisciplinary Thoracic Oncology and Department of Surgery, University Medical Centre Mannheim, Mannheim, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Manegold
mesh_terms: D000818:Animals; D001859:Bone Neoplasms / Q000191:economics / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000191:economics / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002986:Clinical Trials as Topic; D017048:Health Care Costs; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D058990:Molecular Targeted Therapy / Q000191:economics; D059408:Pain Management; D011788:Quality of Life