Use of bisphosphonates and other bone supportive agents in the management of prostate cancer—A UK perspective

Abstract

Bone is the most common site of metastatic spread in men with prostate cancer, occurring in up to 90% of advanced cases. 1,2 Studies have shown that within 2 years, without preventive therapy, 33-46% of men with non-metastatic castration-resistant prostate cancer (nmCRPC) and biochemical progression on androgen deprivation therapy (ADT) developed bone metastases. 3,4 The presence of bone metastases is associated with shortened survival. In one study, 1-and 5-year overall survival rates of 47% and 3% and 87% and 56% in patients with and without bone metastases, respectively, have been reported, 5 whereas in another study cancer-specific mortality at 5 years was 58% in men with exclusively bone metastases, 45% in those with exclusively lymph node metastases and 63% in those with visceral metastases alone. 6 In an analysis of data from the control arm of the STAMPEDE trial,