ABSTRACT

Introduction

Prolonged use of anti-cancer treatments in breast and prostate tumors alters physiological bone turnover leading to adverse skeletal related events, such as osteoporosis, loss of bone mass, and increased risk of fractures. These complications known as cancer treatment-induced bone loss (CTIBL) should be managed with bone targeting agents such as the bisphosphonates and denosumab. The latter is a monoclonal antibody against the receptor activator of nuclear factor-kB ligand (RANKL) that suppresses osteoclasts function and survival increasing bone mass.

Areas covered

This review will focus on the mechanisms associated with bone loss induced by cancer treatments and the most recent evidence about the use of denosumab as preventive and therapeutic strategy to protect bone health. Moreover, we will discuss several key aspects regarding the clinical practical use of denosumab to optimize the management of CTLIB in breast and prostate cancer.

Expert opinion

Denosumab treatment strongly prevents cancer therapies-related skeletal issues in breast and prostate cancer with a good safety profile. Adjuvant six-monthly denosumab delays the time to first fracture onset in early stage breast cancer patients with normal or altered bone mineral density (BMD). Similarly, denosumab treatment is able to prevent fractures and BMD loss in nonmetastatic prostate cancer patients.

中文翻译：

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地诺单抗用于治疗与癌症有关的骨质流失。

摘要

介绍

在乳腺和前列腺肿瘤中长期使用抗癌治疗会改变生理性骨转换，从而导致不良的骨骼相关事件，例如骨质疏松症，骨量减少和骨折风险增加。这些并发症，如癌症治疗引起的骨丢失（CTIBL），应使用双膦酸盐和denosumab等骨靶向药物进行治疗。后者是针对核因子-kB配体（RANKL）受体激活剂的单克隆抗体，可抑制破骨细胞功能和存活率增加的骨量。

覆盖区域

这篇综述将集中在与癌症治疗引起的骨质流失相关的机制上，以及有关使用地诺单抗作为预防和治疗策略来保护骨骼健康的最新证据。此外，我们将讨论有关地诺单抗在临床上实际使用的几个关键方面，以优化乳腺癌和前列腺癌CTLIB的管理。

专家意见

地诺单抗治疗具有良好的安全性，可有效预防乳腺癌和前列腺癌中与癌症治疗相关的骨骼问题。具有正常或改变的骨矿物质密度（BMD）的早期乳腺癌患者，每6个月加一次地诺单抗可延迟首次骨折发作的时间。类似地，denosumab治疗能够预防非转移性前列腺癌患者的骨折和BMD丢失。