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Updated: Apr 8, 2026
An Orthotopic Murine Model of Human Prostate Cancer Metastasis
Published on: September 18, 2013
Targeting bone metastases in prostate cancer: improving clinical outcome
Jean-Jacques Body1, Sandra Casimiro2, Luís Costa2
1Department of Medicine, CHU Brugmann, Department of Medicine, Place Van Gehuchten, 1020 Brussels, Belgium.
Abstract:
Bone metastases develop in most patients with metastatic castration-resistant prostate cancer (mCRPC). They affect the structural integrity of bone, manifesting as pain and skeletal-related events (SREs), and are the primary cause of patient disability, reduced quality of life (QOL) and death. Understanding the pathophysiology of bone metastases resulted in the development of agents that improve clinical outcome, suggesting that managing both the systemic disease and associated bone events is important. Historically, the treatment of CRPC bone metastases with early radiopharmaceuticals and external beam radiation therapy was largely supportive; however, now, zoledronic acid and denosumab are integral to the therapeutic strategy for mCRPC. These agents substantially reduce skeletal morbidity and improve patient QOL. Radium-223 dichloride is the first bone-targeting agent to show improved survival and reduced pain and symptomatic skeletal events in patients with mCRPC without visceral disease. Five other systemic agents are currently approved for use in mCRPC based on their ability to improve survival. These include the cytotoxic drugs docetaxel and cabazitaxel, the hormone-based therapies, abiraterone and enzalutamide, and the immunotherapeutic vaccine sipuleucel-T. Abiraterone and enzalutamide are able to reduce SREs and improve survival in this setting. Novel agents targeting tumour and bone cells are under clinical development.
Insights
Bone metastases significantly impact patients with metastatic castration-resistant prostate cancer (mCRPC), causing pain and skeletal events. Newer therapies improve survival and quality of life by targeting bone and systemic disease.
Area of Science:
- Oncology
- Bone Metastasis Research
- Prostate Cancer Therapeutics
Background:
- Bone metastases are a major complication in metastatic castration-resistant prostate cancer (mCRPC), leading to pain, skeletal-related events (SREs), disability, and reduced quality of life (QOL).
- Understanding the mechanisms of bone metastasis has driven the development of targeted therapies.
- Effective management requires addressing both the systemic cancer and its skeletal complications.
Purpose of the Study:
- To review the current understanding of bone metastasis pathophysiology in mCRPC.
- To highlight the evolution of therapeutic strategies for managing bone metastases in mCRPC.
- To discuss the impact of novel agents on patient outcomes.
Main Methods:
- Review of current literature on bone metastases in mCRPC.
- Analysis of therapeutic agents including bone-modifying agents, radiopharmaceuticals, and systemic therapies.
- Evaluation of clinical outcomes such as survival, SREs, and QOL.
Main Results:
- Bisphosphonates (zoledronic acid) and denosumab are standard treatments reducing skeletal morbidity and improving QOL.
- Radium-223 dichloride offers improved survival and reduced symptoms in mCRPC patients without visceral disease.
- Systemic agents like docetaxel, cabazitaxel, abiraterone, enzalutamide, and sipuleucel-T improve survival, with abiraterone and enzalutamide also reducing SREs.
Conclusions:
- Therapeutic strategies for mCRPC bone metastases have advanced significantly, moving beyond supportive care.
- Bone-targeting agents and systemic therapies play crucial roles in improving survival and QOL.
- Ongoing research into novel agents targeting tumor and bone cells holds promise for future treatment advancements.
