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Updated: May 14, 2026

Osteoclast Derivation from Mouse Bone Marrow
Published on: November 6, 2014
Prostate cancer and osteoporosis
Stephen P Tuck1, Birgit Hanusch, Julie Walker
1Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. Stephen.tuck@stees.nhs.uk
Prostate cancer treatments like androgen deprivation therapy weaken bones. Denosumab, a RANKL inhibitor, effectively reduces fractures and bone density loss in prostate cancer patients, potentially outperforming zoledronic acid.
Area of Science:
- Oncology
- Endocrinology
- Bone Metabolism
Background:
- Prostate cancer is a prevalent malignancy with increasing survival rates.
- Prostate cancer and its treatments, particularly androgen deprivation therapy (ADT), significantly increase risks of bone density loss, fractures, and skeletal-related events.
- Existing treatments like bisphosphonates show efficacy in bone loss reversal but lack anti-fracture data.
Purpose of the Study:
- To review the impact of bone density loss and fractures in prostate cancer patients.
- To evaluate the efficacy of denosumab, a RANKL inhibitor, in mitigating bone complications associated with prostate cancer and ADT.
- To compare denosumab with zoledronic acid in managing skeletal-related events.
Main Methods:
- Literature review of studies on prostate cancer, bone density, fractures, and skeletal-related events.
- Analysis of clinical trial data for bisphosphonates, zoledronic acid, and denosumab in prostate cancer patients.
- Examination of comparative studies assessing denosumab versus zoledronic acid.
Main Results:
- Androgen deprivation therapy (ADT) accelerates bone loss and increases fracture risk in prostate cancer patients.
- Denosumab has demonstrated significant increases in bone density and reductions in fracture rates.
- Both zoledronic acid and denosumab effectively reduce skeletal-related events in metastatic prostate cancer, with denosumab showing potential advantages.
Conclusions:
- Denosumab represents a promising therapeutic option for managing bone density loss and fracture risk in prostate cancer patients undergoing ADT.
- Denosumab is effective in reducing skeletal-related events and may offer superior outcomes compared to zoledronic acid.
- Further comparative studies are warranted to fully elucidate the long-term benefits and optimal use of denosumab in prostate cancer bone management.
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