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Published on: September 26, 2016

Anti-resorptive agents in neuroendocrine bone metastases - A systematic review

Marianne S Elston1,2, Colin Chan Chui2, Jade A U Tamatea1,2

  • 1Endocrinology Unit, Te Whatu Ora Waikato, Waikato Hospital, New Zealand.

Journal of Bone Oncology
|August 9, 2026
PubMed
Abstract

Insights

Anti-resorptive agents show limited evidence for treating bone metastases in neuroendocrine neoplasms (NENs). More research, including prospective trials, is needed to clarify their role and efficacy in managing skeletal complications in NEN patients.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Bone metastases are a frequent complication in patients with neuroendocrine neoplasms (NENs), often leading to skeletal-related events.
  • The efficacy and safety of anti-resorptive agents in this specific patient population remain largely unknown.

Purpose of the Study:

  • To systematically review the current literature on the use of anti-resorptive agents in patients with well-differentiated neuroendocrine neoplasms (NENs) and bone metastases.
  • To evaluate the impact of these agents on survival, skeletal-related events (SREs), and treatment toxicity.

Main Methods:

  • A systematic review was conducted following PRISMA guidelines, searching multiple databases (Embase, Medline, PubMed, Google Scholar, Cochrane, Web of Science).
  • Studies reporting the use of anti-resorptive agents in NEN patients with bone metastases were identified and selected for full-text review.
  • Five retrospective studies involving 348 patients (206 treated with anti-resorptives) were included.

Main Results:

  • Evidence regarding the role of anti-resorptive agents in NENs with bone metastases is limited and heterogeneous.
  • One study suggested improved survival with monthly bisphosphonates, while others found no significant survival difference.
  • One study reported a reduction in SREs, and toxicity was noted in 15.2% of patients in one study.

Conclusions:

  • There is insufficient evidence to establish the role of anti-resorptive agents in managing bone metastases in neuroendocrine neoplasms.
  • Prospective clinical trials are necessary to determine the efficacy, safety, and optimal use of these agents in NEN patients.
Keywords:
BisphosphonatesBone metastasesDenosumabDiphosphonatesNeuroendocrine neoplasmNeuroendocrine tumour

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