Purpose: Platelet-derived growth factor α (PDGFRα) is highly expressed in primary prostate cancer and associated skeletal metastases. Here, we tested whether targeting this receptor could impair metastatic colonization and progression, as well as prolong survival, either as primary or as combination therapy.Experimental Design: We used a preclinical animal model of metastasis in which PC3-ML human prostate cancer cells are inoculated directly in the blood circulation. First, the humanized, monoclonal antibody IMC-3G3 was administered to mice bearing established skeletal metastases. Second, we targeted the stromal PDGFRα with IMC-1E10, an antibody specific for the murine receptor. Third, IMC-3G3 and the bisphosphonate zoledronic acid (ZA), administered separately or in combination, were tested on the progression of skeletal lesions and overall survival. In addition, the ability of IMC-3G3 and ZA to impair initial colonization of the bone marrow by prostate cancer cells was investigated.Results: The blockade of PDGFRα on prostate cancer cells by IMC-3G3 reduces the size of established skeletal metastases, whereas the IMC-1E10 antibody directed against the stromal PDGFRα fails to inhibit metastatic progression. IMC-3G3 and ZA, either separately or in combination, significantly slow tumor growth and seem to prolong survival. Lastly, the blockade of PDGFRα by IMC-3G3 inhibits the initial phase of bone colonization, whereas ZA is ineffective at this stage.Conclusion: This study presents compelling evidence that targeting PDGFRα with IMC-3G3 delays the progression of early metastatic foci and reduces the size of more established lesions. In addition, IMC-3G3, either alone or in combination with ZA, prolongs survival in animal models. Although skeletal metastases occur with a significantly high rate in patients affected by advanced prostate carcinoma (1, 2), a limited range of options is currently available for the treatment of metastatic bone lesions (3, 4). Equally frustrating is the evidence that the burden deriving from skeletal dissemination represents the main cause of death for these patients, but the current standard of care for advanced prostate cancer produces merely palliative effects (5). Skeletal metastases cause bone resorption and chronic pain and predispose patients to skeletal-related events such as pathologic fractures and spinal cord compression. This skeletal morbidity is presently treated with the administration of bisphosphonates in prophylactic and adjuvant settings (6). Bisphosphonates are inorganic pyrophosphates that inhibit the enzymatic activities of osteoclasts, the cells responsible for the degradation of bone matrix (7,8). These compounds are effective in alleviating bone loss and pain, as well as reducing the occurrence of skeletal-related events (9, 10). However, bisphosphonates are not without side effects, including renal toxicity, hypocalcemia, and osteonecrosis of the jaw, which may prevent their long-term administration in bone-metastatic prostate cancer patients (11,12).In ...