Long-term benefits versus side-effects from bone-targeted therapies for cancer patients: minimizing risk while maximizing benefits

Curr Opin Support Palliat Care. 2014 Dec;8(4):420-8. doi: 10.1097/SPC.0000000000000084.

Abstract

Purpose of review: Bone-targeted therapies such as bisphosphonates and denosumab are established in the treatment of cancer patients to prevent or delay skeletal-related events and improve quality of life. Along with these benefits of bone-targeted therapies, there are also known risks and adverse effects.

Recent findings: Although historically bone-targeted therapy use has been limited to palliation in patients with bone metastases, recent evidence suggests that these agents may also have anti-cancer effects. This will likely lead to the greater use of these agents in patients with earlier-stage disease. Increased use will lead to more adverse effects. In particular, the risk of rare but severe toxicities will become important.

Summary: This article explores strategies to maximize the clinical benefit of such therapy while minimizing associated risks.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biomarkers
  • Bisphosphonate-Associated Osteonecrosis of the Jaw
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / secondary*
  • Bone and Bones / pathology
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Denosumab
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects
  • Diphosphonates / therapeutic use*
  • Female
  • Humans
  • Palliative Care
  • Patient Selection
  • Quality of Life
  • Risk Factors

Substances

  • Antibodies, Monoclonal, Humanized
  • Biomarkers
  • Bone Density Conservation Agents
  • Diphosphonates
  • Denosumab