Metastatic Prostate Cancer and the Bone: Significance and Therapeutic Options

摘要: Abstract Context Skeletal involvement is common in metastatic prostate cancer (PCa) and associated with skeletal-related events (SREs). The interaction of PCa the bone microenvironment contributes to self-perpetuating progression bone. Bone-targeted agents (BTAs) are available for use castration-resistant (mCRPC). Objective To review biology metastases clinical trial data BTAs PCa. Evidence acquisition A literature search was conducted October 2014. Keywords included trial, cancer, denosumab, bisphosphonates, zoledronic acid, radium-223, turnover markers, events, symptomatic skeletal . synthesis summarized. Data supporting reviewed, issues related combination sequencing discussed. Conclusions osteoclast-targeted acid denosumab decrease SREs mCRPC, α-emitting radiopharmaceutical agent radium-223 improves survival decreases events. Limited guide sequence disease-modifying agents, although support drugs chemotherapy, androgen-targeted radium-223. Zoledronic does not reduce when started prior castration resistance, do improve outcomes used patients asymptomatic minimally chemotherapy-naive mCRPC. optimal chemotherapy uncertain, suggest efficacy tolerability similar either sequence. Clinical trials evaluating other under way. optimization strategies will best agents. Patient summary pertaining current understanding having spread complications