Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies

Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown...

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Main Authors: Tilman Todenhöfer, Arnulf Stenzl, Lorenz C. Hofbauer, Tilman D. Rachner
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2015/838202
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author Tilman Todenhöfer
Arnulf Stenzl
Lorenz C. Hofbauer
Tilman D. Rachner
author_facet Tilman Todenhöfer
Arnulf Stenzl
Lorenz C. Hofbauer
Tilman D. Rachner
author_sort Tilman Todenhöfer
collection DOAJ
description Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown to improve bone mineral density (BMD) and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs) in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.
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issn 1687-8337
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spelling doaj-art-43e32ae2bd1c4b9ab0fa0b13ddacd7552025-02-03T06:42:07ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/838202838202Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and ControversiesTilman Todenhöfer0Arnulf Stenzl1Lorenz C. Hofbauer2Tilman D. Rachner3Department of Urology, University Hospital, Hoppe-Seyler-Straße 3, 72076 Tübingen, GermanyDepartment of Urology, University Hospital, Hoppe-Seyler-Straße 3, 72076 Tübingen, GermanyDepartment of Medicine III, Technische Universität Dresden Medical Center, Fetscherstraße 74, 01307 Dresden, GermanyDepartment of Medicine III, Technische Universität Dresden Medical Center, Fetscherstraße 74, 01307 Dresden, GermanyMaintaining bone health remains a clinical challenge in patients with prostate cancer (PC) who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL), antiresorptive agents have been shown to improve bone mineral density (BMD) and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs) in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.http://dx.doi.org/10.1155/2015/838202
spellingShingle Tilman Todenhöfer
Arnulf Stenzl
Lorenz C. Hofbauer
Tilman D. Rachner
Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
International Journal of Endocrinology
title Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
title_full Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
title_fullStr Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
title_full_unstemmed Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
title_short Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies
title_sort targeting bone metabolism in patients with advanced prostate cancer current options and controversies
url http://dx.doi.org/10.1155/2015/838202
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AT arnulfstenzl targetingbonemetabolisminpatientswithadvancedprostatecancercurrentoptionsandcontroversies
AT lorenzchofbauer targetingbonemetabolisminpatientswithadvancedprostatecancercurrentoptionsandcontroversies
AT tilmandrachner targetingbonemetabolisminpatientswithadvancedprostatecancercurrentoptionsandcontroversies