The low and disproportionate utilization of antiresorptive therapy in patients with osseous metastasis

Agarwal, Amil R.; LiBrizzi, Christa L.; Wessel, Lauren; Thakkar, Savyasachi C.; Levin, Adam S.

doi:10.1016/j.jbo.2023.100507

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…With worldwide age-standardized incidence rates (ASIR) in 2020 of 47.8 per 100,000 for breast cancer (female) and 30.7 per 100,000 for prostate cancer (male), the two most common malignant tumors separated by gender enable a large group of patients to be treated with these medications ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Antiresorptive agents enhance ossification of free flap reconstructions of the mandible: a radiological retrospective cohort study

Gottsauner,

Meier,

Eichberger

et al. 2024

Front. Oncol.

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BackgroundThe aim of this study was to investigate the effect of antiresorptive agents on the ossification of reconstructed mandibles by free bone grafts for the first time.MethodsA total of 38 reconstructions of the jaw were retrospectively evaluated for ossification between bone segments by two raters based on postoperative panoramic radiographs. The study group (n = 13) had segmental resection of the mandible and free bone flap reconstruction due to medication-related osteonecrosis of the jaw (MRONJ). The control group (noMRONJ, n = 25) comprised segmental mandibular resections and free bone flap reconstructions due to tumors, chronic osteomyelitis, or trauma without any radiation. Ossification time and influencing factors were evaluated.ResultsBoth duration of surgery (346 ± 90 min. vs. 498 ± 124 min.; p < 0.001) and hospitalization (8.7 ± 2.8 days vs. 13.4 ± 5.3 days, p = 0.006) were shorter in the MRONJ group compared to the noMRONJ group. Ossification after mandibular reconstruction was significantly faster in the MRONJ study group [224 days, interquartile range (IQR) 175–287] compared to the control group (288 days, IQR 194–445; p < 0.001). Moreover, good initial contact between the segments resulted in faster ossification (p < 0.001) in the MRONJ group. Ossification rate between original and grafted bone or between grafted bone segments only did not differ in both the study and control groups (MRONJ, p = 0.705 vs. control, p = 0.292). The type of antiresorptive agent did not show any significance for ossification. The rate of wound healing disturbances did also not differ between the study and control groups (p = 0.69).ConclusionAdvanced MRONJ (stage 3) can be resected and reconstructed safely with free microvascular bone flaps. Antiresorptive agents enhance the ossification of the bone segments. Optimal initial contact of the bone segments accelerates bone healing. Surgery and hospitalization are markedly shortened in this vulnerable group of MRONJ patients compared to oncologic patients.

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Section: Introductionmentioning

confidence: 99%

“…In addition to the treatment of bone metastases, antiresorptive therapy is well-established for multiple myeloma. With more than 150,000 cases a year worldwide in 2020, these patients set an additional part of the oncological prescriptions of antiresorptive drugs (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Antiresorptive agents enhance ossification of free flap reconstructions of the mandible: a radiological retrospective cohort study

Gottsauner,

Meier,

Eichberger

et al. 2024

Front. Oncol.

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From Tumor to Bone: Growth Factor Receptors as Key Players in Cancer Metastasis

Mohammad,

Akhund

2024

Front. Biosci. (Landmark Ed)

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This review article explores the intricate correlation between growth factors and bone metastases, which play a crucial role in the development of several types of malignancies, namely breast, prostate, lung, and renal cancers. The focal point of our discussion is on crucial receptors for growth factors, including Epidermal Growth Factor Receptor (EGFR), Transforming Growth Factor-β (TGFβ), Vascular Endothelial Growth Factor Receptor (VEGFR), and Fibroblast Growth Factor Receptor (FGFR). These receptors, which are essential for cellular activities including growth, differentiation, and survival, have important involvement in the spread of cancer and the interactions between tumors and the bone environment. We discuss the underlying mechanisms of bone metastases, with a specific emphasis on the interaction between growth factor receptors and the bone microenvironment. EGFR signaling specifically enhances the process of osteoclast development and the formation of osteolytic lesions, especially in breast and lung malignancies. TGFβ receptors have a role in both osteolytic and osteoblastic metastases by releasing TGFβ, which attracts cancer cells and promotes bone remodeling. This is a crucial element in the spread of prostate cancer to the bones. The functions of FGFR and VEGFR in the processes of bone formation and tumor angiogenesis, respectively, highlight the complex and diverse nature of these interactions. The review emphasizes the possibility of targeted therapeutics targeting these receptors to interrupt the cycle of tumor development and bone degradation. Therapeutic approaches include focusing on the VEGF/VEGFR, EGF/EGFR, FGF/FGFR, and TGFβ/TGFβR pathways. These include a variety of compounds, such as small molecule inhibitors and monoclonal antibodies, which have shown potential to interfere with tumor-induced alterations in bone. The text discusses clinical trials and preclinical models, offering insights into the effectiveness and constraints of various treatments. Ultimately, this study provides a succinct but thorough summary of the present knowledge and treatment strategies focused on growth factor receptors in bone metastases. This highlights the significance of comprehending the signaling of growth factor receptors in the microenvironment where tumors spread to the bones, as well as the possibility of using targeted therapies to enhance the results for cancer patients with bone metastases. The advancement of treating bone metastases hinges on the development of treatments that specifically target the intricate relationships between malignancies and bone.

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The low and disproportionate utilization of antiresorptive therapy in patients with osseous metastasis

Cited by 2 publications

References 21 publications

Antiresorptive agents enhance ossification of free flap reconstructions of the mandible: a radiological retrospective cohort study

Antiresorptive agents enhance ossification of free flap reconstructions of the mandible: a radiological retrospective cohort study

From Tumor to Bone: Growth Factor Receptors as Key Players in Cancer Metastasis

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