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Current approaches to bone-targeted therapy in genitourinary malignancies.
MedLine Citation:
PMID:  23024704     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Bone metastases in patients with genitourinary cancers are associated with increased risk for skeletal-related events including pathologic fractures, spinal cord compression, and the requirement for surgery or palliative radiotherapy to bone. The nitrogen-containing bisphosphonate zoledronic acid and the monoclonal antibody against RANK, denosumab, are approved for the prevention of skeletal-related events in genitourinary cancers. These agents have different mechanisms of action and pharmacokinetic profiles, and while both are effective in reducing the risk of skeletal-related events, other clinical effects differ. There is evidence for direct and indirect anticancer activity with zoledronic acid from preclinical studies and emerging data from clinical studies suggesting an effect on patient survival. Potential anticancer mechanisms include inhibition of angiogenesis, enhanced immune surveillance via stimulation of γδ T cells, and reduction of circulating tumor cells. A synergistic effect of chemotherapy plus zoledronic acid has also been suggested. Further research is ongoing regarding the roles of these antiresorptive therapies in patients with bone metastases or at high risk for malignant spread to skeletal sites.
Authors:
Peter F Mulders
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Therapeutic advances in urology     Volume:  4     ISSN:  1756-2880     ISO Abbreviation:  Ther Adv Urol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2012-10-02     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101487328     Medline TA:  Ther Adv Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  219-32     Citation Subset:  -    
Affiliation:
Department of Urology, Radboud University Medical Centre, PO Box 9101, HB 6500, Nijmegen, The Netherlands.
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