Optimal management of bone metastases in breast cancer patients

MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbiditie...

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Autores principales:	Wong MH, Pavlakis N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3678e13c266c49debc90ca1d654698d4
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spelling	oai:doaj.org-article:3678e13c266c49debc90ca1d654698d42021-12-02T00:27:40ZOptimal management of bone metastases in breast cancer patients1179-1314https://doaj.org/article/3678e13c266c49debc90ca1d654698d42011-05-01T00:00:00Zhttp://www.dovepress.com/optimal-management-of-bone-metastases-in-breast-cancer-patients-a7303https://doaj.org/toc/1179-1314MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.Keywords: breast cancer, bone metastases, bisphosphonates, denosumab, biomarkers, optimal managementWong MHPavlakis NDove Medical PressarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2011, Iss default, Pp 35-60 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Wong MH Pavlakis N Optimal management of bone metastases in breast cancer patients
description	MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.Keywords: breast cancer, bone metastases, bisphosphonates, denosumab, biomarkers, optimal management
format	article
author	Wong MH Pavlakis N
author_facet	Wong MH Pavlakis N
author_sort	Wong MH
title	Optimal management of bone metastases in breast cancer patients
title_short	Optimal management of bone metastases in breast cancer patients
title_full	Optimal management of bone metastases in breast cancer patients
title_fullStr	Optimal management of bone metastases in breast cancer patients
title_full_unstemmed	Optimal management of bone metastases in breast cancer patients
title_sort	optimal management of bone metastases in breast cancer patients
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/3678e13c266c49debc90ca1d654698d4
work_keys_str_mv	AT wongmh optimalmanagementofbonemetastasesinbreastcancerpatients AT pavlakisn optimalmanagementofbonemetastasesinbreastcancerpatients
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Optimal management of bone metastases in breast cancer patients

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