New results from the use of bisphosphonates in cancer patients.
New results from the use of bisphosphonates in cancer patients.
复制标题
DOI：
10.1097/spc.0b013e32832f4149
复制
发表时间：
2009-09-01
影响因子：
2.1
通讯作者：
Gnant, Michael
中科院分区：
文献类型：
--
作者：
Coleman, Robert;Gnant, Michael
审查目的：转移性骨疾病是由骨髓微环境中的癌-骨细胞相互作用而不是癌细胞的直接破坏引起的。此外，癌症治疗可能对骨骼健康产生不利影响。因此，一个明确的理由存在骨靶向治疗，以防止骨骼并发症和潜在的修改潜在的diseases.Recent发现：转移性疾病的研究集中在细化治疗，主要是通过使用骨代谢标志物。在早期癌症中使用双膦酸盐对预防骨质流失变得越来越重要。最近的结果，特别是唑来膦酸，表明骨密度可以保持正常，骨转换增加。双膦酸盐是骨溶解的有效抑制剂，可能会阻碍骨转移的发展和骨髓微环境中休眠细胞的存活。此外，双膦酸盐可能对肿瘤细胞有直接影响，特别是与化疗联合使用。乳腺癌与氯膦酸盐的临床试验结果是不确定的，但最近的数据与唑来膦酸表明，双膦酸盐可能确实修改的过程中的diseases.SUMMARY：的作用，双膦酸盐在转移性骨疾病和预防癌症治疗引起的骨丢失已被定义。然而，在推荐常规辅助性双膦酸盐之前，需要正在进行的转移预防试验的结果。
PURPOSE OF REVIEW: Metastatic bone disease results from cancer-bone cell interactions in the bone marrow microenvironment rather than direct destruction by cancer cells. Additionally, cancer treatments may have adverse effects on bone health. Therefore, a clear rationale exists for bone-targeted therapies to prevent skeletal complications and potentially modify the underlying disease.RECENT FINDINGS: Studies in metastatic disease have focused on refining treatment, largely through the use of bone metabolism markers. Use of bisphosphonates in early cancer has become increasingly important to prevent bone loss. Recent results, notably with zoledronic acid, indicate that bone mineral density can be maintained and increased bone turnover normalized. Bisphosphonates are potent inhibitors of bone osteolysis and may impede both the development of bone metastases and survival of dormant cells in the marrow microenvironment. Additionally, bisphosphonates may have direct effects on tumour cells, especially in combination with chemotherapy. Clinical trial results in breast cancer with clodronate were inconclusive, but recent data with zoledronic acid suggest that bisphosphonates may indeed modify the course of the disease.SUMMARY: The roles of bisphosphonates in metastatic bone disease and the prevention of cancer treatment induced bone loss have been defined. However, results from ongoing metastasis prevention trials are required before routine adjuvant bisphosphonates can be recommended.