title: Long-term benefits versus side-effects from bone-targeted therapies for cancer patients: minimizing risk while maximizing benefits.
abstract: OBJECTIVE
  Bone-targeted therapies such as bisphosphonates and denosumab are established in the treatment of cancer patients to prevent or delay skeletal-related events and improve quality of life. Along with these benefits of bone-targeted therapies, there are also known risks and adverse effects.
  
  
  RESULTS
  Although historically bone-targeted therapy use has been limited to palliation in patients with bone metastases, recent evidence suggests that these agents may also have anti-cancer effects. This will likely lead to the greater use of these agents in patients with earlier-stage disease. Increased use will lead to more adverse effects. In particular, the risk of rare but severe toxicities will become important.
  
  
  CONCLUSIONS
  This article explores strategies to maximize the clinical benefit of such therapy while minimizing associated risks.
authors.affiliation: Division of Medical Oncology, University of Ottawa & Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Carmel
authors.initials: C
authors.lastname: Jacobs
authors.forename: Terry
authors.initials: T
authors.lastname: Ng
authors.forename: Michael
authors.initials: M
authors.lastname: Ong
authors.forename: Mark
authors.initials: M
authors.lastname: Clemons
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D015415:Biomarkers; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001842:Bone and Bones / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D000069448:Denosumab; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010166:Palliative Care; D018579:Patient Selection; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000069448:Denosumab