Onkológia 4/2012

Systemic therapy of bone metastases

Complications of bone metastases can seriously influence quality of life of the patients including of their independence in activities of daily living. Bisfosfonates are reducing skeletal morbidity in solid tumors and in multiple myeloma by 30 − 50% (1). They are not only used in active antineoplastic therapy in the prevention of skeletal complications by bone metastases but they are also significantly usefull in prevention of the decrease of osseous mass by hormonal manipulation. Preclinical and in part clinical data suppose that there is some role of bisfosfonates in prevention of formation of metastases by early cancer. Denosumab is fully humanized antibody against RANKL (receptor activator of nuclear factor κ-B ligand) which is very important in pathogenesis of bone resorption induced by osteoclasts. In this work we discuss about pathological mechanisms of bone resorption in multiple myeloma and solid tumors, we resume data from randomized clinical trials and we focus on the application of antiresorption therapy in clinical practice.

Keywords: bone resorption, RANKL, bisfosfonates, denosumab.