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All bone metastases are not created equal: Revisiting treatment resistance in renal cell carcinoma
Journal of Bone Oncology ( IF 3.4 ) Pub Date : 2021-10-20 , DOI: 10.1016/j.jbo.2021.100399
Ava Brozovich 1, 2, 3 , Benjamin Garmezy 4 , Tianhong Pan 5 , Liyun Wang 6 , Mary C Farach-Carson 7 , Robert L Satcher 5
Affiliation  

Renal cell carcinoma (RCC) is the most common malignancy of the kidney, representing 80–90% of renal neoplasms, and is associated with a five-year overall survival rate of approximately 74%. The second most common site of metastasis is bone. As patients are living longer due to new RCC targeting agents and immunotherapy, RCC bone metastases (RCCBM) treatment failure is more prevalent. Bone metastasis formation in RCC is indicative of a more aggressive disease and worse prognosis. Osteolysis is a prominent feature and causes SRE, including pathologic fractures. Bone metastasis from other tumors such as lung, breast, and prostate cancer, are more effectively treated with bisphosphonates and denosumab, thereby decreasing the need for palliative surgical intervention. Resistance to these antiresportives in RCCBM reflects unique cellular and molecular mechanisms in the bone microenvironment that promote progression via inhibition of the anabolic reparative response. Identification of critical mechanisms underlying RCCBM induced anabolic impairment could provide needed insight into how to improve treatment outcomes for patients with RCCBM, with the goals of minimizing progression that necessitates palliative surgery and improving survival.



中文翻译:

并非所有骨转移都是平等的:重新审视肾细胞癌的治疗耐药性

肾细胞癌 (RCC) 是最常见的肾脏恶性肿瘤,占肾肿瘤的 80-90%,五年总生存率约为 74%。第二个最常见的转移部位是骨。随着新的 RCC 靶向药物和免疫疗法的出现,患者的寿命越来越长,RCC 骨转移 (RCCBM) 治疗失败的情况也更加普遍。RCC 中骨转移的形成表明疾病更具侵袭性且预后更差。骨溶解是一个突出的特征,会导致 SRE,包括病理性骨折。双磷酸盐和狄诺塞麦可以更有效地治疗肺癌、乳腺癌和前列腺癌等其他肿瘤的骨转移,从而减少姑息性手术干预的需要。RCCBM 对这些抗反应药物的耐药性反映了骨微环境中独特的细胞和分子机制,通过抑制合成代谢修复反应来促进进展。识别 RCCBM 引起的合成代谢障碍的关键机制可以为如何改善 RCCBM 患者的治疗结果提供所需的见解,目标是最大限度地减少需要姑息手术的进展并提高生存率。

更新日期:2021-10-22
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