Bone-modifying Agents (BMAs) in Breast Cancer

Shapiro, Charles L.

doi:10.1016/j.clbc.2021.04.009

Cited by 13 publications

(6 citation statements)

References 160 publications

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“…In premenopausal women bone loss is as high as −7% per year for GnRH agonists with concomitant AIs, and up to −7.7% for ovarian failure secondary to chemotherapy. 13 – 15 …”

Section: Bone Health In Cancer Patientsmentioning

confidence: 99%

Review of bone health in women with estrogen receptor–positive breast cancer receiving endocrine therapy

Malagrinò

Zavatta

2023

Womens Health (Lond Engl)

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In estrogen-receptor-positive tumors, adjuvant endocrine therapy has been shown to be highly beneficial for both overall and disease-free survival. Estradiol is key in regulating bone and mineral physiology, and several studies found a strong correlation between these therapies and the risk of fractures. Since these therapies are often given for 5 through 10 years, the timing for bisphosphonates or denosumab initiation seems essential to managing bone metabolism. However, gray zones and discrepancies between guidelines remain as to the best threshold when to start antiresorptive treatment, or whether antiresorptive treatment should be administered to every woman undergoing adjuvant endocrine therapy, independent of their risk factors for fractures. Treatment options and strategies should be discussed at the start of hormone adjuvant therapy to come to a shared decision with the patient, with the final aim of reducing the risk of future fractures as much as possible. This review will cover present guidelines and literature on antiresorptive treatment in this setting, to provide clinicians with useful clues for managing these patients.

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“…In premenopausal women bone loss is as high as −7% per year for GnRH agonists with concomitant AIs, and up to −7.7% for ovarian failure secondary to chemotherapy. 13 – 15 …”

Section: Bone Health In Cancer Patientsmentioning

confidence: 99%

Review of bone health in women with estrogen receptor–positive breast cancer receiving endocrine therapy

Malagrinò

Zavatta

2023

Womens Health (Lond Engl)

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“…Bone-targeted agents (BTAs) are the most popular drugs used for patients suffering from spine metastases. BTAs can decrease the incidence of skeletal-related events (SREs) including pathological fractures, pain, and hypercalcemia, which are common problems in these patients [ 142 , 143 , 144 , 145 ]. In light of extending the overall survival of oncological patients with bone metastases due to more and more effective anticancer treatment, the role of BTAs increases significantly [ 146 ].…”

Section: Bone-targeted Agentsmentioning

confidence: 99%

Biological and Clinical Aspects of Metastatic Spinal Tumors

Litak

Czyżewski

Szymoniuk

et al. 2022

Cancers

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Spine metastases are a common life-threatening complication of advanced-stage malignancies and often result in poor prognosis. Symptomatic spine metastases develop in the course of about 10% of malignant neoplasms. Therefore, it is essential for contemporary medicine to understand metastatic processes in order to find appropriate, targeted therapeutic options. Thanks to continuous research, there appears more and more detailed knowledge about cancer and metastasis, but these transformations are extremely complicated, e.g., due to the complexity of reactions, the variety of places where they occur, or the participation of both tumor cells and host cells in these transitions. The right target points in tumor metastasis mechanisms are still being researched; that will help us in the proper diagnosis as well as in finding the right treatment. In this literature review, we described the current knowledge about the molecular pathways and biomarkers engaged in metastatic processes involving the spine. We also presented a current bone-targeted treatment for spine metastases and the emerging therapies targeting the discussed molecular mechanisms.

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“…Bisphosphonates form ATP-conjugates and this way they block activation of osteoclast in bone resorption and induce their apoptosis. The second generation bisphosphonates (amino-BF) have another mechanism of action, they are effective prenylation inhibitors by this secondary activity they activate macrophages and T cells resulting in the increased TNFa and IL-6 levels (10). These differences in mechanism of action are important to understand the development of side effects upon their application (11).…”

Section: Bone Metastasis Inhibitors: Bisphosphonates and Anti-rankl A...mentioning

confidence: 99%

“…Caused by activation of macrophages and release of inflammatory cytokines. On the other hand, in case of anti-RANKL antibody therapies infections may emerge due to the fact that these antibodies accumulate in lymph nodes as well, where their inhibitory effect on macrophages may result in the inhibition of acute inflammatory responses (9,10). Today, bone metastasis therapies can be combined with anti-angiogenic therapeutics which further increase the risk of development of osteonecrosis, since bone remodeling and regeneration in case of periodontitis requires also formation of novel capillaries (12,13,14).…”

Section: Bone Metastasis Inhibitors: Bisphosphonates and Anti-rankl A...mentioning

confidence: 99%

On-Target Side Effects of Targeted Therapeutics of Cancer

Tı́már¹,

Uhlyarik²

2022

Pathol. Oncol. Res.

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The concept of precision medicine is based on the identification of hallmarks of cancer to exploit them as drug targets. The basic idea was that in this way the therapeutic modalities will be more effective and the side effects will be less. Since the majority of these novel modalities are not specific for a cancer-related biological process or a cancer-specific (mutant) target protein, it is not a surprise that we had to learn new type of side effects, because these therapeutics also affect physiological or pathological processes. Even more, in cases of some of these novel therapies we were able to discover new molecular mechanisms of physiological and pathological processes. Identification of the on-target side effects of targeted drugs can help to prevent the development of them or better manage the patients when emerge during cancer therapy.

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Bone-modifying Agents (BMAs) in Breast Cancer

Cited by 13 publications

References 160 publications

Review of bone health in women with estrogen receptor–positive breast cancer receiving endocrine therapy

Review of bone health in women with estrogen receptor–positive breast cancer receiving endocrine therapy

Biological and Clinical Aspects of Metastatic Spinal Tumors

On-Target Side Effects of Targeted Therapeutics of Cancer

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