Bonetargeted treatments

Zoledronic Acid. Metastatic prostate cancer has an affinity to spread to the bone. Bone metastases occur in up to 90% of patients with HRPC. These metastases can lead to significant morbidity, including severe pain, fractures, and spinal cord compression tumors in the bone may cause pain, compression, or pathologic fratures, known as skeletal related events (SRE's). Because of the frequent involvement of vertebrae by metastatic prostate cancer, the incidene of cord compression is of particular concern. Zoledronic acid has been shown to prevent or delay skeletal complications in men with bone metastases, as well as to palliate bone pain [74, 75]. At an average followup of 24 months, there was a significant reduction in the frequency of skeletal related events (SREs) in men receiving zoledronic acid compared to placebo [38 versus 49 percent), and the median time to develop an SRE was significantly longer with zoledronic acid [488 versus 321 days) [76]. Biphosphonates may also have a role in preventing osteopenia that frequently accompanies the use of androgen-deprivation therapy [77, 78]

Denosumab. Is a human monoclonal antibody directed against RANKL that inhibits osteo-clast-mediated bone destruction. In a phase III study [79]. Denosumab showed to be better than zoledronic acid for the prevention of skeletal-related events. Although is not yet available in Europe, it is expected to be approved soon.

0 0

Post a comment