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Updated: Jul 31, 2025
Intra-Cardiac Injection of Human Prostate Cancer Cells to Create a Bone Metastasis Xenograft Mouse Model
Published on: November 4, 2022
Management of bone metastasis in prostate cancer
1Department of Urology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. kazuo.nishimura@oici.jp.
Abstract:
Progression of bone metastases is the primary cause of death in prostate cancer, and skeletal-related events (SREs), including pathologic fractures, spinal cord compression, radiation, or surgery to bone can impair patients' quality of life. Over the past decade, the development of cytotoxic agents, androgen-receptor-axis-targeted therapies (ARATs), and radioligand therapies has prolonged overall survival of prostate cancer patients with bone metastases and reduced the risk of SREs. The use of bone-modifying agents has also contributed to the reduced risk of SREs. Initial use of a cytotoxic agent, docetaxel, or an ARAT agent with androgen deprivation therapy (ADT) is the current approach to metastatic castration-sensitive prostate cancer. However, there is no consensus on the optimal medication for upfront use in combination with ADT, or on specific patient selection. Recently, next-generation imaging modalities, such as whole-body magnetic resonance imaging and prostate-specific membrane antigen-positron emission tomography have been utilized to detect bone metastases at an early stage. In addition, metastasis-directed therapy, such as stereotactic body radiation therapy, has been attempted. In the future, patients with bone metastatic prostate cancer will be divided into subgroups and their treatment options will be tailored to their specific characteristics.
Insights
Treatments for prostate cancer bone metastases have improved survival and reduced skeletal-related events (SREs). Future strategies will involve personalized treatment based on patient subgroups and advanced imaging.
Area of Science:
- Oncology
- Medical Imaging
- Radiation Oncology
Background:
- Bone metastases significantly impact prostate cancer mortality and patient quality of life, causing skeletal-related events (SREs).
- Recent advancements in cytotoxic agents, androgen-receptor-axis-targeted therapies (ARATs), and radioligand therapies have improved survival and reduced SREs.
- Bone-modifying agents also play a role in mitigating SREs.
Purpose of the Study:
- To review current treatment approaches for metastatic castration-sensitive prostate cancer (mCSPC) with bone metastases.
- To discuss the lack of consensus on optimal upfront therapy in combination with androgen deprivation therapy (ADT).
- To highlight emerging diagnostic and therapeutic strategies for bone metastatic prostate cancer.
Main Methods:
- Review of recent literature on prostate cancer bone metastases treatment.
- Analysis of the impact of cytotoxic agents, ARATs, radioligand therapies, and bone-modifying agents.
- Evaluation of novel imaging techniques and metastasis-directed therapies.
Main Results:
- Cytotoxic agents, ARATs, and radioligand therapies have extended survival and decreased SREs in prostate cancer patients with bone metastases.
- Next-generation imaging (e.g., whole-body MRI, PSMA-PET) aids in early detection of bone metastases.
- Metastasis-directed therapies like stereotactic body radiation therapy are being explored.
Conclusions:
- Current treatment for mCSPC involves upfront cytotoxic or ARAT agents with ADT, but optimal selection remains unclear.
- Personalized treatment strategies tailored to patient subgroups will likely guide future management of bone metastatic prostate cancer.
- Integration of advanced imaging and targeted therapies promises improved outcomes for patients with bone metastases.
