Bone health and therapeutic agents in advanced prostate cancer

Abstract

Prostate cancer is the most frequent genitourinary tumor worldwide. Maintaining an optimum bone health throughout the natural course of prostate cancer is an important aspect in the management of this disease, particularly in this at risk population of older and frail patients who experience bone loss related to androgen-deprivation therapy (ADT) and/or patients who develop bone metastases. The number of treatment options for advanced prostate cancer that combine ADT with docetaxel, new hormonal agents and/or radiotherapy has increased substantially in recent years. Bisphosphonates and other bone targeted agents such as denosumab have shown an improvement in bone mineral density and are suited for patients with treatment-related osteoporosis and/or bone metastases with an increased risk of skeletalrelated events (SREs). In this context, the aim of this review is to analyse key aspects of bone health and therapies that can prevent the occurrence of SREs throughout the clinical course of prostate cancer, and how to combine them with new available treatments in this setting.

Micro-computed tomography assessment of bone structure in aging mice

“…In an osteoarthritis mouse model, treatment with FSH accelerates inflammatory cytokine production and stimulates osteoclastogenesis, while treatment with E2 shows opposite effects 69 . Osteoporosis is also induced during androgen deprivation therapy in prostate cancers, as well with aging, in men 70 , 71 . Treatments with dihydrotestosterone and/or E2 improves suppressed cell viability due to oxidative stress in pre-osteoblasts, but not in mature osteoblasts 72 .…”