title: Medical treatment of breast cancer bone metastasis: from bisphosphonates to targeted drugs.
abstract: Breast cancer bone metastasis causing severe morbidity is commonly encountered in daily clinical practice. It causes pain, pathologic fractures, spinal cord and other nerve compression syndromes and life threatening hypercalcemia. Breast cancer metastasizes to bone through complicated steps in which numerous molecules play roles. Metastatic cells disrupt normal bone turnover and create a vicious cycle to which treatment efforts should be directed. Bisphosphonates have been used safely for more than two decades. As a group they delay time to first skeletal related event and reduce pain, but do not prevent development of bone metastasis in patients with no bone metastasis, and also do not prolong survival. The receptor activator for nuclear factor κB ligand inhibitor denosumab delays time to first skeletal related event and reduces the skeletal morbidity rate. Radionuclides are another treatment option for bone pain. New targeted therapies and radionuclides are still under investigation. In this review we will focus on mechanisms of bone metastasis and its medical treatment in breast cancer patients.
authors.affiliation: Departments of Medical Oncology, Agri State Hospital, Turkey E-mail : berdoga@hotmail.com.
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.forename: Irfan
authors.initials: I
authors.lastname: Cicin
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D001842:Bone and Bones / Q000473:pathology / Q000502:physiology; D001943:Breast Neoplasms / Q000473:pathology*; D000069448:Denosumab; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010146:Pain / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D053245:RANK Ligand / Q000037:antagonists & inhibitors; D011877:Radionuclide Imaging
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D004164:Diphosphonates; D053245:RANK Ligand; D000069448:Denosumab