Role of osteoclast inhibitors in prostate cancer bone metastasis; a narrative review

Shariq Ahmad Wani1, Salma Qudrat2, Hina Zubair3

  • 1Department of Internal Medicine, Government medical college, Srinagar, India.

Abstract

Insights

Osteoclast inhibitors, such as bisphosphonates and denosumab, effectively reduce skeletal events in advanced prostate cancer bone metastasis. These treatments improve patient quality of life by managing pain and preventing fractures.

Area of Science:

  • Oncology
  • Pharmacology
  • Bone Metastasis Research

Background:

  • Prostate cancer frequently metastasizes to the skeleton, causing significant morbidity including pain, fractures, and spinal cord compression.
  • Skeletal-related events (SREs) substantially reduce quality of life and increase disability in patients with advanced prostate cancer.
  • Historically, radiation and radiopharmaceuticals were primary treatments for bone metastases.

Purpose of the Study:

  • To evaluate the role of osteoclast inhibitors in treating advanced prostate cancer metastasis.
  • To assess the efficacy of osteoclast inhibitors in reducing skeletal-related events (SREs).

Main Methods:

  • A comprehensive literature search was conducted on PubMed and Google Scholar.
  • Keywords included "osteoclast inhibitors," "Bisphosphonates," "Zoledronic acid," "pamidronate," "Alendronate," "Denosumab," and "Prostate cancer metastasis."
  • Relevant articles were screened, collected, and synthesized to review the use of osteoclast inhibitors in prostate cancer bone metastasis.

Main Results:

  • Osteoclast inhibitors, including bisphosphonates and denosumab, are now integral to managing metastatic prostate cancer.
  • These agents significantly decrease the incidence of SREs.
  • Emerging therapies like Radium-223 show promise in reducing SREs and improving survival.
  • Other treatments like chemotherapy (Docetaxel, cabazitaxel), hormonal therapies (abiraterone, enzalutamide), and immunotherapy (sipuleucel-T) are also utilized.

Conclusions:

  • Osteoclast inhibitors are effective in mitigating SREs in advanced prostate cancer with bone metastasis.
  • These therapies demonstrably improve the quality of life for affected patients.

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