title: Bone targeted therapy for preventing skeletal-related events in metastatic breast cancer.
abstract: Cancer cells can alter physiological mechanisms within bone resulting in high bone turnover, and consequently in skeletal-related events (SREs), causing severe morbidity in affected patients. The goals of bone targeted therapy, as bisphosphonates and denosumab, are the reduction of incidence and the delay in occurrence of the SREs, to improve quality of life and pain control. The toxicity profile is similar between bisphosphonates and denosumab, even if pyrexia, bone pain, arthralgia, renal failure and hypercalcemia are more common with bisphosphonates, while hypocalcemia and toothache are more frequently reported with denosumab. Osteonecrosis of the jaw (ONJ) occurred infrequently without statistically significant difference. The present review aims to provide an assessment on bone targeted therapies for preventing the occurrence of SREs in bone metastatic breast cancer patients, critically analyzing the evidence available so far on their effectiveness, in light of the different mechanisms of action. Thus, we try to provide tools for the most fitting treatment of bone metastatic breast cancer patients. We also provide an overview on the usefulness of bone turnover markers in clinical practice and new molecules currently under study for the treatment of bone metastatic disease.
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy. Electronic address: azzurra.irelli@hotmail.it.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Irelli
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cocciolone
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Cannita
authors.affiliation: Radiology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Zugaro
authors.affiliation: Radiation Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Di Staso
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Lanfiuti Baldi
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Paradisi
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Tina
authors.initials: T
authors.lastname: Sidoni
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ricevuto
authors.affiliation: Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Ficorella
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000517:prevention & control* / Q000556:secondary*; D016723:Bone Remodeling; D001842:Bone and Bones / Q000473:pathology*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D058990:Molecular Targeted Therapy
chemical_list: D050071:Bone Density Conservation Agents
keywords: Bisphosphonates; Denosumab; Metastatic breast cancer; Skeletal-related events