Bisphosphonates and RANK ligand inhibitors for the treatment and prevention of metastatic bone disease
Bisphosphonates and RANK ligand inhibitors for the treatment and prevention of metastatic bone disease
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DOI：
10.1016/j.ejca.2010.02.041
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发表时间：
2010-05-01
影响因子：
8.4
通讯作者：
Coleman, R. E.
中科院分区：
文献类型：
--
作者：
Neville-Webbe, H. L.;Coleman, R. E.
双膦酸盐（BPS）是破骨细胞介导的骨吸收的有效抑制剂，当癌细胞侵入骨时，骨吸收增加。BPS是一种已扩散到骨骼的癌症的既定治疗方法，并有效地减少疼痛和其他与骨骼相关的事件。转移性骨疾病（MBD）的新方向包括个性化BP治疗，例如使用骨标志物指导BP给药频率和骨靶向药物，如地舒单抗（AMG 162）。临床试验强烈表明，地舒单抗可能在未来的MBD管理中发挥明确的作用。就潜在的抗癌活性而言，早期数据初步表明唑来膦酸可能在预防转移性疾病中发挥作用，尽管这是否是对癌细胞的直接影响，或通过骨髓微环境间接影响，或两者兼而有之，尚未发现。关于辅助BP在早期癌症中的作用的明确答案正在得到解决，目前有超过20，000名乳腺癌，前列腺癌或肺癌患者参加了辅助BP随机试验。这些试验的结果将在未来几年内公布，这将确定在癌症早期给予BP是否能够预防骨转移或其他转移的形成。皇冠版权所有（C）2010由爱思唯尔有限公司出版。保留所有权利。
Bisphosphonates (BPS) are potent inhibitors of osteoclast-mediated bone resorption, which is increased when cancer cells invade bone. BPS are an established treatment for cancer that has spread to bone, and effectively reduce pain and other skeletal-related events. New directions in metastatic bone disease (MBD) include personalised BP therapy, such as using bone markers to guide frequency of BP administration and bone targeting agents such as denosumab (AMG 162). Clinical trials strongly suggest that denosumab might play a defined role in the future management of MBD. In terms of potential anti-cancer activity, early data tentatively suggest that zoledronic acid might have a role to play in the prevention of metastatic disease, though whether this is a direct effect on cancer cells, or indirect via the bone marrow micro-environment, or both, is as yet undiscovered. The definitive answer as to the role of adjuvant BP in early cancer is being addressed, with over 20,000 patients with breast, prostate or lung cancer currently participating in adjuvant BP randomised trials. The results of these trials should be available in the next few years, and this will establish whether BPs given early in the course of cancer will be able to prevent the formation of metastases, bone or otherwise. Crown Copyright (C) 2010 Published by Elsevier Ltd. All rights reserved.