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Related Concept Videos

Targeted Cancer Therapies02:57

Targeted Cancer Therapies

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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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Microtubules are dynamic structures and can be regulated by microtubule targeting agents (MTAs). Microtubule destabilizing drugs are a class of MTAs that destabilize and prevent microtubules' polymerization. Both natural and synthetic chemicals can be found under this class of drugs. Vincristine and vinblastine, two vinca alkaloids, and colchicine were among the first to be discovered. These drugs can affect cells in various ways, either by inducing a change in cell morphology, preventing...
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Related Experiment Video

Updated: Nov 4, 2025

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines
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Bone-modifying Agents (BMAs) in Breast Cancer.

Charles L Shapiro1

  • 1Icahn School of Medicine at Mt Sinai, New York, NY.

Clinical Breast Cancer
|May 28, 2021
PubMed
Summary

Bone-modifying agents (BMAs) help prevent and treat osteoporosis and reduce skeletal complications in breast cancer patients. Newer evidence suggests BMAs may also prevent skeletal metastases and improve survival, with updated dosing regimens showing promise.

Keywords:
Aromatase InhibitorsBone metastasesDenosumabOsteoporosisZoledronic acid

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Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Bone-modifying agents (BMAs) are crucial for managing osteoporosis and skeletal metastases in breast cancer patients.
  • Bone loss is a significant concern with treatments like chemotherapy, GnRH agonists, and aromatase inhibitors, increasing fracture risk.
  • Current recommendations include risk assessment, calcium/vitamin D3 supplementation, DEXA scans, and pharmacological intervention when indicated.

Purpose of the Study:

  • To review the mechanism of action, clinical trial data, and adverse events of bone-modifying agents in breast cancer.
  • To discuss the role of BMAs in preventing and treating osteoporosis and skeletal metastases.
  • To highlight updated treatment strategies and dosing for agents like zoledronic acid and denosumab.

Main Methods:

  • This narrative review synthesizes information from randomized clinical trials and existing literature.
  • It examines the efficacy and safety profiles of bisphosphonates and denosumab.
  • The review also considers the specific applications of BMAs in different menopausal statuses and treatment settings.

Main Results:

  • Zoledronic acid (ZA) and denosumab (DEN) effectively reduce skeletal-related events in advanced disease.
  • Every 3-month administration of ZA has demonstrated noninferiority to monthly dosing, establishing a new standard of care.
  • ZA shows an anticancer effect primarily in postmenopausal women or those rendered postmenopausal by specific therapies.

Conclusions:

  • BMAs are essential for bone health in breast cancer patients, offering benefits in both early and advanced stages.
  • Optimized dosing schedules, such as every 3-month ZA, improve treatment convenience and adherence.
  • Adjuvant ZA is recommended for high-risk pre- and postmenopausal women undergoing GnRH agonist therapy or oophorectomy, while DEN data is limited in this context.