Optimal sequence of bone target drugs in metastatic prostatic cancer

Breast, prostate, lung and kidney cancer all manifest with a high predilection for metastasis to bone, which is a prevalent cause of morbidity, increased risk of death and decreased quality of life for patients. The avidity of some cancers to grow in bone is because of the peculiar microenvironment predisposed by bone. In metastatic prostate cancer, many novel therapeutic agents are programmed to contrast the signal pathway, including the androgen receptor, osteoclast and stromal inhibitors. Therapy with new drugs in prostate cancer has been shown to decrease the risk of skeletal-related complications and, therefore, provide an overall survival and quality of life benefit. An improved sequence of administration of these drugs may improve efficacy.