Adverse effects of the cancer therapy on osteoclast-mediated bone loss in patients with cancers: a challenge

Abstract

It is well-known that cancer therapies, including chemotherapy drugs, aromatase inhibitors and gonadotropin-releasing homone analogues, commonly contribute to remarkably reduce the bone mineral density, subsequently increase the rate of bone loss. For instance, in the patients with prostate cancer treated with androgene deprivation therapy (ADT), or chemotherapy drugs such as doxorubicin and cisplatin the calcicum levels were significantly decreased in the body, thereby leading to bone loss. Besides, the aromatase inhibitors widely used to treat breast cancer, and antiresorptive agents targeting the receptor activator of nuclear factor кB ligand can also trigger bone loss. Osteoclasts (OCs), derived from monocyte/macrophage lineage, are deifferentiated into mature, multinucleated OCs (a process also known as osteoclastogenesis) via a series of osteoclastogenic signaling pathways, are responsible for resorbing bone. This review article characterizes and summarizes the adverse effects of chemotherapy drugs on accelerating OC-induced bone defects such as the increased bone resorption and the impaired bone mineral density (BMD) in the patients with cancers.