“…In vitro studies show that tumor cells and osteoclasts, once activated by pro-inflammatory cytokines with bone resorption activity, secrete Cathepsin L, which participates in degrading bone matrix, thus allowing the homing of metastatic cells into the bone tissue [119-122, 127, 130-135]. These findings are consistent with recent in vitro observations, which demonstrate that the expression levels of Cathepsin L in tumor tissue are increased by proinflammatory cytokines with bone resorption activity such as IL-1b, IL-6 or TNF-a [67,68,[120][121][122][123][124][125]. Furthermore, Cathepsin L may indirectly promote bone degradation by triggering the activation of latent precursor forms of other proteolytic enzymes, such as MMPs, uPA and heparanase, which are known to foster metastatic cascade and bone remodeling processes [8,43,45,119,136].…”