title: Bone-Targeted Agents for the Management of Breast Cancer Patients with Bone Metastases.
abstract: Despite advances in adjuvant therapy for breast cancer, bone remains the most common site of recurrence. The goal of therapy for these patients is palliative and focused on maximizing the duration and quality of their life, while concurrently minimizing any disease or treatment-related complications. Bone metastases predispose patients to reduced survival, pain, impaired quality of life and the development of skeletal-related events. With an increased understanding of the pathophysiology of bone metastasis, effective treatments for their management have evolved and are now in widespread clinical use. This article will discuss the pathogenesis of bone metastases and review the key clinical evidence for the efficacy and safety of currently available systemic bone-targeted therapies in breast cancer patients with an emphasis on bisphosphonates and the receptor activator of nuclear factor kappa B ligand (RANKL) inhibitors. We will also discuss novel strategies and therapies currently in development.
authors.affiliation: Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa Hospital Research Institute, Box 900, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada. dsimos@toh.on.ca.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Simos
authors.affiliation: Centre for Cancer Therapeutics, The Ottawa Hospital Research Institute, Departments of Medicine & Biochemistry Microbiology & Immunology, University of Ottawa, Box 926, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada. caddison@ohri.ca.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Addison
authors.affiliation: Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa Hospital Research Institute, Box 900, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada. ikuchuk@toh.on.ca.
authors.forename: Iryna
authors.initials: I
authors.lastname: Kuchuk
authors.affiliation: Centre for Practice Changing Research & Ottawa Hospital Research Institute, Box 201, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada. bhutton@ohri.ca.
authors.forename: Brian
authors.initials: B
authors.lastname: Hutton
authors.affiliation: Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa Hospital Research Institute, Box 900, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada. smazz052@uottawa.ca.
authors.forename: Sasha
authors.initials: S
authors.lastname: Mazzarello
authors.affiliation: Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa Hospital Research Institute, Box 900, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada. mclemons@toh.on.ca.
authors.forename: Mark
authors.initials: M
authors.lastname: Clemons
keywords: bisphosphonates; bone metastases; bone-targeted therapy; denosumab; skeletal-related events