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Takeuchi T, Tanaka S, Murata M, Tanaka Y. Irreversible covalent Bruton's tyrosine kinase inhibitor, TAS5315 versus placebo in rheumatoid arthritis patients with inadequate response to methotrexate: a randomised, double-blind, phase IIa trial. Ann Rheum Dis 2023; 82:1025-1034. [PMID: 37217273 PMCID: PMC10359550 DOI: 10.1136/ard-2022-223759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To examine the efficacy and safety of TAS5315, an irreversible covalent Bruton's tyrosine kinase inhibitor, in Japanese patients with rheumatoid arthritis (RA) refractory to methotrexate. METHODS In part A of this phase IIa double-blind study, patients were randomised to TAS5315 4 or 2 mg or placebo once daily for 12 weeks; in part B, all patients received TAS5315 for another 24 weeks. The proportion of patients meeting American College of Rheumatology criteria for 20% improvement (ACR20) at week 12 was assessed (primary endpoint). RESULTS Ninety-one patients were randomised in part A, and 84 entered part B. At week 12, 78.9% of patients achieved ACR20 in the TAS5315 combined group vs 60.0% with placebo (p=0.053), 33.3% vs 13.3% achieved ACR50 (p=0.072) and 7.0% vs 0.0% achieved ACR70 (p=0.294), respectively. More patients receiving TAS5315 than placebo had low disease activity or remission at week 12. Clinical and biomarker improvements were maintained during part B. Adverse event (AE) incidence in TAS5315 was similar to placebo in part A; common AEs with TAS5315 were nasopharyngitis (10.3%), pruritus (6.9%) and cystitis (5.2%). Over 36 weeks, nine patients experienced bleeding events of whom four and two patients recovered with drug continuation and interruption, respectively. Three patients recovered after TAS5315 discontinuation. CONCLUSIONS The primary endpoint was not achieved. TAS5315 appears to have some bleeding risks, but nevertheless demonstrated numerical differences, compared with placebo, in the improvement rates of all measures of RA disease activity. Future analysis of the risk-benefit of TAS5315 should be considered. TRIAL REGISTRATION NUMBERS NCT03605251, JapicCTI-184020, jRCT2080223962.
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Affiliation(s)
- Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Saitama Medical University, Saitama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
- Clinical Research Center for Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Shibata M, Okumura M, Kawano S, Noda H, Toyota C, Mizuno Y. Denosumab effect on bone mineral density and urinary-NTX in breast cancer patients receiving aromatase inhibitors. J Bone Miner Metab 2023:10.1007/s00774-023-01429-8. [PMID: 37247110 DOI: 10.1007/s00774-023-01429-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/06/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Aromatase inhibitors are used post-surgical intervention in postmenopausal patients with breast cancer. However, these drugs accelerate decline in bone mineral density (BMD), which is countered by use of denosumab, and the efficacy of the drug can be assessed by bone turnover markers. We investigated the effects of denosumab administration for 2 years on BMD and urinary N-telopeptide of type I collagen (u-NTX) levels in breast cancer patients treated with aromatase inhibitors. MATERIALS AND METHODS This was a single-center retrospective study. Postoperative hormone receptor-positive breast cancer patients with low T-scores biannually received denosumab from the time of initiation of aromatase inhibitor therapy for 2 years. BMD was measured every 6 months, and u-NTX levels were assessed after 1 month and thereby every 3 months. RESULTS The median patient age of the 55 patients included in this study was 69 (range: 51-90) years. BMD gradually increased in the lumbar spine and femoral neck and u-NTX levels were lowest at 3 months post-initiation of therapy. Patients were divided into two groups based on the change ratio of u-NTX 3 months post-denosumab administration. Of these, the group with higher change ratio showed a higher degree of BMD restoration in the lumbar spine and femoral neck 6 months post-denosumab treatment. CONCLUSION Denosumab increased BMD in patients treated with aromatase inhibitors. The u-NTX level decreased soon after start of denosumab treatment, and its change ratio is predictive of improvement in BMD.
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Affiliation(s)
- Masahiro Shibata
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan.
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan.
| | - Mai Okumura
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan
| | - Shin Kawano
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan
| | - Hirotoshi Noda
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan
| | - Chihiro Toyota
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan
| | - Yutaka Mizuno
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi-City, Mie, 510-8567, Japan
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Rojo RD, Perez JVD, Damasco JA, Yu G, Lin SC, Heralde FM, Novone NM, Santos EB, Lin SH, Melancon MP. Combinatorial effect of radium-223 and irreversible electroporation on prostate cancer bone metastasis in mice. Int J Hyperthermia 2021; 38:650-662. [PMID: 33882773 PMCID: PMC8495630 DOI: 10.1080/02656736.2021.1914873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Metastatic prostate cancer in bone is difficult to treat as the tumor cells are relatively resistant to hormonal or chemotherapies when compared to primary prostate cancer. Irreversible electroporation (IRE) is a minimally invasive ablation procedure that has potential applications in the management of prostate cancer in bone. However, a common limitation of IRE is tumor recurrence, which arises from incomplete ablation that allows remaining cancer cells to proliferate. In this study, we combined IRE with radium-223 (Ra-223), a bone-seeking radionuclide that emits short track length alpha particles and thus is associated with reduced damage to the bone marrow and evaluated the impact of the combination treatment on bone-forming prostate cancer tumors. METHODS The antitumor activity of IRE and Ra-223 as single agents and in combination was tested in vitro against three bone morphogenetic protein 4 (BMP4)-expressing prostate cancer cell lines (C4-2B-BMP4, Myc-CaP-BMP4, and TRAMP-C2-BMP4). Similar evaluation was performed in vivo using a bone-forming C4-2B-BMP4 tumor model in nude mice. RESULTS IRE and Ra-223 as monotherapy inhibited prostate cancer cell proliferation in vitro, and their combination resulted in significant reduction in cell viability compared to monotherapy. In vivo evaluation revealed that IRE with single-dose administration of Ra-233, compared to IRE alone, reduced the rate of tumor recurrence by 40% following initial apparent complete ablation and decreased the rate of proliferation of incompletely ablated tumor as quantified in Ki-67 staining (53.58 ± 16.0% for IRE vs. 20.12 ± 1.63%; for IRE plus Ra-223; p = 0.004). Histological analysis qualitatively showed the enhanced killing of tumor cells adjacent to bone by Ra-223 compared to those treated with IRE alone. CONCLUSION IRE in combination with Ra-223, which enhanced the destruction of cancer cells that are adjacent to bone, resulted in reduction of tumor recurrence through improved clearance of proliferative cells in the tumor region.
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Affiliation(s)
- Raniv D. Rojo
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States of America,College of Medicine, University of the Philippines Manila, Pedro Gil St., Ermita, Manila, National Capital Region 1000, Republic of the Philippines
| | - Joy Vanessa D. Perez
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States of America,College of Medicine, University of the Philippines Manila, Pedro Gil St., Ermita, Manila, National Capital Region 1000, Republic of the Philippines
| | - Jossana A. Damasco
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States of America
| | - Guoyu Yu
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas, 77030, United States of America
| | - Song-Chang Lin
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas, 77030, United States of America
| | - Francisco M. Heralde
- College of Medicine, University of the Philippines Manila, Pedro Gil St., Ermita, Manila, National Capital Region 1000, Republic of the Philippines
| | - Nora M. Novone
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas, 77030, United States of America
| | - Elmer B. Santos
- Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas, 77030, United States of America
| | - Sue-Hwa Lin
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas, 77030, United States of America,MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, 6767 Bertner Ave., Houston, Texas, 77030, United States of America
| | - Marites P. Melancon
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States of America,MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, 6767 Bertner Ave., Houston, Texas, 77030, United States of America
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4
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Gentile M, Centonza A, Lovero D, Palmirotta R, Porta C, Silvestris F, D'Oronzo S. Application of "omics" sciences to the prediction of bone metastases from breast cancer: State of the art. J Bone Oncol 2020; 26:100337. [PMID: 33240786 PMCID: PMC7672315 DOI: 10.1016/j.jbo.2020.100337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/28/2022] Open
Abstract
Breast cancer (BC) is the first cause of cancer-related death in women. Most patients with advanced BC develop bone metastases (BM). Omics technologies have been applied to identify putative BM “predicting” biomarkers. Prospective studies are needed before any clinical application of such biomarkers.
Breast cancer (BC) is the most frequent malignancy and the first cause of cancer-related death in women. The majority of patients with advanced BC develop skeletal metastases which may ultimately lead to serious complications, termed skeletal-related events, that often dramatically impact on quality of life and survival. Therefore, the identification of biomarkers able to stratify BC patient risk to develop bone metastases (BM) is fundamental to define personalized diagnostic and therapeutic strategies, possibly at the earliest stages of the disease. In this regard, the advent of “omics” sciences boosted the investigation of several putative biomarkers of BC osteotropism, including deregulated genes, proteins and microRNAs. The present review revisits the current knowledge on BM development in BC and the most recent studies exploring potential BM-predicting biomarkers, based on the application of omics sciences to the study of primary breast malignancies.
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Key Words
- ADAMTS1, a disintegrin-like and metalloproteinase with thrombospondin type 1
- ALP, alkaline phosphatase
- BALP (BSAP), bone-specific alkaline phosphatase
- BC, breast cancer
- BM, bone metastases
- BOLCs, breast osteoblast-like cells
- BTM, bone turnover markers
- Biomarkers
- Bone metastases
- Breast cancer
- CAPG, capping-protein
- CCN3, cellular communication network factor 3
- CDH11, cadherin-11
- CNV, copy number variation
- CTGF, connective tissue-derived growth factor
- CTSK, cathepsin K
- CTX, C-telopeptide
- CXCL, C-X-C-ligand
- CXCR, C–X–C motif chemokine receptor
- DEGs, differentially expressed genes
- DOCK4, dedicator of cytokinesis protein 4
- DPD, deoxypyridoline
- DTC, disseminated tumour cells
- EMT, epithelial-to-mesenchymal transition
- ER, estrogen receptor
- ERRα, estrogen-related receptor alpha
- FAK, focal adhesion kinase
- FGF, fibroblast growth factor
- FST, follistatin
- GIPC1, PDZ domain-containing protein member 1
- HR, hazard ratio
- Her, human epidermal growth factor
- ICAM-1, intercellular adhesion molecule 1
- IGF, insulin-like growth factor
- IHC, immunohistochemistry
- IL, interleukin
- LC/MS/MS, liquid chromatography/mass spectrometry/mass spectrometry
- MAF, v-maf avian muscolo aponeurotic fibro-sarcoma oncogene homolog
- MDA-MB, MD Anderson metastatic BC
- MMP1, matrix metalloproteinase-1
- NTX, N-telopeptide
- OPG, osteoprotegerin
- Omics sciences
- Osteotropism
- P1CP, pro-collagen type I C-terminal
- P1NP, pro-collagen type I N-terminal
- PDGF, platelet-derived growth factor
- PRG1, proteoglycan-1
- PTH-rP, parathyroid hormone-related protein
- PYD, pyridoline
- PgR, progesterone receptor
- PlGF, placental growth factor
- RANK, receptor activator of nuclear factor к-B
- RT-PCR, real time-PCR
- SILAC-MS, stable isotope labelling by amino acids in cell culture-mass spectrometry
- SNPs, single nucleotide polymorphisms
- SPP1, osteopontin
- SREs, skeletal-related events
- TCGA, the cancer genome atlas
- TGF-β, transforming growth factor beta
- TNF-α, tumor necrosis factor-α
- TRACP-5b, tartrate resistant acid phosphatase-5b
- VEGF, vascular endothelial growth factor
- ZNF217, zinc-finger protein 217
- miRNAs, microRNAs
- ncRNAs, noncoding RNA
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Affiliation(s)
- Marica Gentile
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Antonella Centonza
- "Casa Sollievo della Sofferenza" Onco-hematologic Department, Medical Oncology Unit, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy
| | - Domenica Lovero
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Raffaele Palmirotta
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Franco Silvestris
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Stella D'Oronzo
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
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5
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Lee KH, Lee KJ, Kim TY, Hutomo F, Sun HJ, Cheon GJ, Park SI, Cho SW, Im SA. Circulating Osteocalcin-Positive Cells as a Novel Diagnostic Biomarker for Bone Metastasis in Breast Cancer Patients. J Bone Miner Res 2020; 35:1838-1849. [PMID: 32379371 DOI: 10.1002/jbmr.4041] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/15/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Abstract
Current diagnosis of bone metastasis (BM) in breast cancer relies on structural changes of bone that occur only in the advanced stage. A sensitive biomarker for detecting early progression of bone metastasis is urgently required. We performed clinical and preclinical studies to investigate diagnostic value of circulating osteocalcin-positive cells (cOC) in breast cancer bone metastasis. Metastatic breast cancer patients (n = 92) with or without bone metastasis (ie, BM+ or BM- ) were enrolled, and cOC were measured at enrollment. Patients were followed up for bone metastasis progression for 18 months. BM+ patients (n = 59) were divided into progressive (PD) or stable disease (SD) groups, based on imaging studies at the end of the 18-month study. The PD group had higher baseline cOC compared with the SD group. Furthermore, higher cOC resulted in reduced BM progression-free survival. Three patients in the BM- group (n = 33) developed new BM during the 18-month study, and these patients had a higher level of baseline cOC compared with the remaining BM- patients. In murine preclinical studies, cOC increased at early time points when micro-metastases were evident only by histology but undetectable by bioluminescence imaging. Also, cOC levels predicted the progression of BM and correlated significantly with BM tumor burden. cOC increased in the early phase of breast cancer BM and can predict BM progression, supporting cOC as a potential novel biomarker. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - Kyoung Jin Lee
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, South Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - Febby Hutomo
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyun Jin Sun
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Serk In Park
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, South Korea.,Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Shizuku M, Shibata M, Okumura M, Takeuchi D, Kikumori T, Mizuno Y. Utility of urinary type I collagen cross-linked N-telopeptide as a prognostic indicator in breast cancer patients with bone metastases. Breast Cancer 2020; 27:1065-1071. [PMID: 32415556 DOI: 10.1007/s12282-020-01109-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer patients with bone metastases are usually managed with bone modifying agents, such as zoledronic acid and denosumab, and some bone turnover markers (BTMs) have been recognized as prognostic indicators in such patients. Although several studies have demonstrated the validity of BTMs as prognostic markers in patients treated with zoledronic acid, few studies have reported the utility of BTMs with denosumab treatment. In this study, we evaluated whether urinary N-telopeptide of type I collagen (u-NTX) can be a prognostic indicator in patients treated with denosumab. METHODS Thirty-six breast cancer patients newly diagnosed with bone metastases were evaluated retrospectively. Patients were treated with denosumab and anti-cancer drugs. u-NTX levels were measured 1 month before and after administration of denosumab, and the ratio of u-NTX levels before and after denosumab (change ratio) was assessed for its association with prognosis. RESULTS Levels of u-NTX decreased after denosumab administration in all patients except for one. The median value of the u-NTX change ratio was 0.766. Based on the change ratio, patients were divided into either a "high group" (n = 18) or a "low group" (n = 18). The low group showed significantly shorter overall survival (OS) compared with the high group (low group 15.0 months; high group 54.0 months; P = 0.012). Multivariate analysis indicated that the "low group" was an independent prognostic factor for OS (P = 0.028). CONCLUSION We demonstrated that the u-NTX change ratio in denosumab-treated breast cancer patients with bone metastases can be a prognostic marker.
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Affiliation(s)
- Masato Shizuku
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie, 510-8567, Japan.,Department of Transplantation and Endocrine Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Masahiro Shibata
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie, 510-8567, Japan. .,Department of Breast and Endocrine Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Mai Okumura
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie, 510-8567, Japan
| | - Dai Takeuchi
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie, 510-8567, Japan.,Department of Breast and Endocrine Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yutaka Mizuno
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie, 510-8567, Japan
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Jiang Z, Tang ET, Li C, Zhu L, Zhang B, Glennane T, Zhang L. What is the relationship between bone turnover markers and skeletal-related events in patients with bone metastases from solid tumors and in patients with multiple myeloma? A systematic review and meta-regression analysis. Bone Rep 2020; 12:100272. [PMID: 32420416 PMCID: PMC7215099 DOI: 10.1016/j.bonr.2020.100272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction As a result of the negative impact of bone metastases on patient quality of life, it is important to identify patients at increased risk of skeletal-related events (SREs). Biochemical markers produced by osteoblasts and osteoclasts may provide an early indicator of treatment response to antiresorptive therapy. We aimed to explore the relationship between change in the urinary bone turnover marker cross-linked N-terminal telopeptide of type 1 collagen (uNTX) at the earliest time of steady state and risk of SREs. Methods A comprehensive search of eight bibliographic databases and two trial registries was conducted (June 2017). We included randomized controlled trials of adults (≥18 years old) with bone metastases from solid tumors (including breast, lung, prostate) or bone lesions from multiple myeloma that compared denosumab or bisphosphonate(s) with each other or a placebo. Meta-analyses were used to evaluate the relationship between uNTX and SREs. The primary outcomes were based on uNTX at week 13 and SREs in those studies. Results Seventeen studies (12,130 patients) were included. The analysis results indicated a positive association between uNTX reduction, measured by the between-group difference of the natural logarithm of the ratio between uNTX at week 13 and baseline, and SRE risk reduction, measured by the natural logarithm of the hazard ratio (HR) for time to first SRE between the two groups (uNTX effect on SRE risk, defined as SRE HR increase corresponding to one unit smaller in the magnitude of uNTX reduction: 0.3560, 95% confidence interval 0.0249-0.6871; P = .0390, R2 = 0.7360). Results were similar for studies that reported change in uNTX from baseline to week 13 and to later than week 13. The limitation of this review is that it depends on how comprehensive study data were that could be included in the meta-regression. Conclusions Our findings support a positive relationship between reduction of bone turnover markers at the earliest time of steady state and reduction in longer-term risk of SREs.
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Affiliation(s)
- Zefei Jiang
- Department of Breast Oncology, The Fifth Medical Center of Chinese PLA General Hospital, No. 100 of West Fourth Ring Middle Road, Fengtai District, Beijing 100071, China
| | - En-Tzu Tang
- Amgen China, RM. 1501-1506, 15F of Platinum Tower, No. 233 Taicang Road, Huangpu District, Shanghai 200020, Shanghai, China
| | - Chuang Li
- Amgen China, RM. 1501-1506, 15F of Platinum Tower, No. 233 Taicang Road, Huangpu District, Shanghai 200020, Shanghai, China
| | - Li Zhu
- Amgen Inc., Mail Stop 27-3 E, 1 Amgen Center Drive, Thousand Oaks, CA 91303, USA
| | - Biao Zhang
- Amgen China, RM. 1501-1506, 15F of Platinum Tower, No. 233 Taicang Road, Huangpu District, Shanghai 200020, Shanghai, China
| | - Tony Glennane
- Amgen Inc., Mail Stop 27-3 E, 1 Amgen Center Drive, Thousand Oaks, CA 91303, USA
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, No. 651 East Dong Feng Road, Guangzhou 510060, China
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8
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Salvador F, Llorente A, Gomis RR. From latency to overt bone metastasis in breast cancer: potential for treatment and prevention. J Pathol 2019; 249:6-18. [PMID: 31095738 PMCID: PMC6771808 DOI: 10.1002/path.5292] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/19/2022]
Abstract
Bone metastasis is present in a high percentage of breast cancer (BCa) patients with distant disease, especially in those with the estrogen receptor‐positive (ER+) subtype. Most cells that escape primary tumors are unable to establish metastatic lesions, which suggests that target organ microenvironments are hostile for tumor cells. This implies that BCa cells must achieve a process of speciation to adapt to the new conditions imposed in the new organ. Bone has unique characteristics that can be exploited by cancer cells: it undergoes constant remodeling and comprises diverse environments (including osteogenic, perivascular, and hematopoietic stem cell niches). This allows colonizing cells to take advantage of numerous adhesion molecules, matrix proteins, and soluble factors that facilitate homing, survival, and, eventually, metastatic outgrowth. However, in most cases, metastatic lesions enter into a latency state that can last months, years, or even decades, before forming a clinically detectable macrometastasis. This dormant state challenges the effectiveness of adjuvant chemotherapy. Detecting which tumors are more prone to metastasize to bone and developing new specific therapies that target bone metastasis represent urgent clinical needs. Here, we review the biological mechanisms of BCa bone metastasis and provide the latest options of treatments and predictive markers that are currently in clinical use or are being tested in clinical assays. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Fernando Salvador
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Alicia Llorente
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Roger R Gomis
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.,CIBERONC, Barcelona, Spain.,ICREA, Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.,School of Medicine, Universitat de Barcelona, Barcelona, Spain
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9
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Niu Y, Lin Y, Pang H, Shen W, Liu L, Zhang H. Risk factors for bone metastasis in patients with primary lung cancer: A systematic review. Medicine (Baltimore) 2019; 98:e14084. [PMID: 30653124 PMCID: PMC6370015 DOI: 10.1097/md.0000000000014084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Bone metastases (BM) are prevalent among lung cancer (LC) patients. Although some studies revealed associated factors for BM, each of these papers focused on a few factors. Few studies have identified the potential risk factors through a systematic review. METHODS We searched through PubMed, MEDLINE, Web of Science, EMBASE, Cochrane Library and Cochrane Central Registerof Controlled Trials for literature from January 1990 to November 2017. The types of literature included case-control studies, cohort studies, randomized controlled trials and systematic reviews. RESULTS From included 12 studies, we identified that lower blood calcium, T4 stage, N3 stage, P-stage III, nonsquamous, bone sialoprotein expression, elevated carcino-embryonic antigen levels were risk factors for bone metastasis in lung cancer patients. CONCLUSION We identified that T4 stage, N3 stage, and positive bone sialoprotein expression associated with an increased risk of bone metastasis. Further studies are needed to assess these relationships and to establish the risk prediction model of bone metastasis.
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Affiliation(s)
- Yujie Niu
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
- Department of Oncology and Hematology, Ningxia People's Hospital
- Department of Oncology and Hematology, The First Affiliated Hospital of Northwest University to Nationalities, Yinchuan, Ningxia
| | - Yiting Lin
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
| | - Hailin Pang
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
| | - Weiwei Shen
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
| | - Lili Liu
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
| | - Helong Zhang
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi
- Cancer Institute, the Fourth Military Medical University, Xi’an, Shaanxi, China
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10
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Shen Y, Jing D, Hao J, Tang G, Yang P, Zhao Z. The Effect of β-Aminopropionitrile on Skeletal Micromorphology and Osteogenesis. Calcif Tissue Int 2018; 103:411-421. [PMID: 29916126 DOI: 10.1007/s00223-018-0430-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
Abstract
Collagen cross-linking, as a form of collagen post-translational modification, plays a crucial role in maintaining bone mechanical properties as well as in regulating cell biological functions. Shifts in cross-links profile are found apparently correlated to kinds of skeletal pathology and diseases, whereas little is known about the relationship between collagen cross-links and osteogenesis. Here, we hypothesized that the inhibition of collagen cross-links could impair skeletal microstructure and inhibit osteogenesis. A mouse model of collagen cross-linking defects has been established using subcutaneous injection of 350 mg/kg β-aminopropionitrile (BAPN) daily for 4 weeks, and same dose of phosphate buffered saline (PBS) served as control group. The analysis of bone microstructural parameters revealed a significant decrease of bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), and increase of bone surface ratio (BS/BV), structure model index (SMI) as well as trabecular separation (Tb.Sp) in the experimental group (p < 0.05), whereas there was no difference observed in bone mineral density (BMD). Histological staining displayed that the BAPN treatment caused thinner trabeculae and decrease of collagen content in proximal tibiae. The analysis of osteogenesis PCR (Polymerase Chain Reaction) array reflected that BAPN remarkably influenced the expression of Alpl, Bglap, Bgn, Bmp5, Col10a1, Col1a1, Col1a2, Col5a1, Itga2b, and Serpinh1. The results of immunohistochemistry displayed a significant reduction in the mean optical densities of OCN and COL1 at the presence of BAPN. The overall results of this study suggested that BAPN alters bone microstructure and hinders the expression of osteogenic genes without affecting mineralization processes, indicating the influences of collagen cross-links on osteogenesis may be a potential pathological mechanism in skeletal diseases.
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Affiliation(s)
- Yu Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, #14, 3rd section of Renmin South Road, Chengdu, 610041, China
| | - Dian Jing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, #14, 3rd section of Renmin South Road, Chengdu, 610041, China
| | - Jin Hao
- Harvard School of Dental Medicine, Harvard University, Cambridge, MA, USA
| | - Ge Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, #14, 3rd section of Renmin South Road, Chengdu, 610041, China
| | - Pu Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, #14, 3rd section of Renmin South Road, Chengdu, 610041, China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, #14, 3rd section of Renmin South Road, Chengdu, 610041, China.
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11
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Ahern E, Smyth MJ, Dougall WC, Teng MWL. Roles of the RANKL–RANK axis in antitumour immunity — implications for therapy. Nat Rev Clin Oncol 2018; 15:676-693. [DOI: 10.1038/s41571-018-0095-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Tsirkinidis P, Terpos E, Boutsikas G, Papatheodorou A, Anargyrou K, Lalou E, Dimitrakopoulou A, Kalpadakis C, Konstantopoulos K, Siakantaris M, Panayiotidis P, Pangalis G, Kyrtsonis MC, Vassilakopoulos T, Angelopoulou MK. Bone metabolism markers and angiogenic cytokines as regulators of human hematopoietic stem cell mobilization. J Bone Miner Metab 2018; 36:399-409. [PMID: 28660376 DOI: 10.1007/s00774-017-0853-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
Hematopoietic stem cell (HSC) mobilization involves cleavage of ligands between HSC and niche components. However, there are scarce data regarding the role of bone cells in human HSC mobilization. We studied biochemical markers of bone metabolism and angiogenic cytokines during HSC mobilization in 46 patients' sera with lymphoma and multiple myeloma, by ELISA. Significant changes between pre-mobilization and collection samples were found: (1) Bone alkaline phosphatase (BALP) increased, indicating augmentation of bone formation; (2) Receptor activator of Nf-κB ligand/osteoprotegerin ratio (RANKL/OPG) increased, showing osteoclastic differentiation and survival; however, there was no evidence of increased osteoclastic activity; and (3) Angiopoietin-1/Angiopoietin-2 ratio (ANGP-1/ANGP-2) decreased, consistent with vessel destabilization. Poor mobilizers had significantly higher carboxy-terminal telopeptide of collagen type I (CTX) and lower ANGP-1 at pre-mobilization samples, compared to good ones. CTX, amino-terminal telopeptide of collagen type I (NTX) and ANGP-1 pre-mobilization levels correlated significantly with circulating CD34+ peak cell counts. Our results indicate that bone formation and vessel destabilization are the two major events during human HSC mobilization. Osteoblasts seem to be the orchestrating cells, while osteoclasts are stimulated but not fully active. Moreover, ANGP-1, CTX and NTX may serve as predictors of poor mobilization.
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Affiliation(s)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Boutsikas
- Department of Hematology, 251 General Air Force Hospital, Athens, Greece
| | | | | | - Eleni Lalou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Aglaia Dimitrakopoulou
- Department of Immunology Research and Flow Cytometry, 'Laiko' General Hospital of Athens, Athens, Greece
| | - Christina Kalpadakis
- Department of Hematology, School of Medicine, University of Crete, Herakleion, Greece
| | - Konstantinos Konstantopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Marina Siakantaris
- 1st Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Panayiotidis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerassimos Pangalis
- Department of Hematology, Psychicon Branch, Athens Medical Center, Athens, Greece
| | - Marie-Christine Kyrtsonis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Maria K Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece.
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13
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Chambard L, Girard N, Ollier E, Rousseau JC, Duboeuf F, Carlier MC, Brevet M, Szulc P, Pialat JB, Wegrzyn J, Clezardin P, Confavreux CB. Bone, muscle, and metabolic parameters predict survival in patients with synchronous bone metastases from lung cancers. Bone 2018; 108:202-209. [PMID: 29337225 DOI: 10.1016/j.bone.2018.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 12/11/2017] [Accepted: 01/04/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Lung adenocarcinoma regularly induces bone metastases that are responsible for impaired quality of life as well as significant morbidity, including bone pain and fractures. We aimed at identifying whether bone and metabolic biomarkers were associated with the prognosis of lung adenocarcinoma patients with synchronous bone metastases. PATIENTS AND METHODS POUMOS is a prospective cohort of patients diagnosed with lung adenocarcinoma and synchronous bone metastases. All patients underwent biopsy of bone metastases to confirm diagnosis, including genotyping of oncogenic drivers such as EGFR and KRAS. Whole-body composition was assessed using DEXA scan. Serum levels of C-reactive protein, HbA1C, calcaemia, sCTX, and DKK1 were also measured. RESULTS Sixty four patients, aged (mean ± SD) 65 ± 11 years, were included. Thirty-nine (61%) patients had a good performance status (PS 0-1); 56% had >5 bone lesions, and 41% a weight-bearing bone (femour or tibia) involvement. Median overall survival was 7 months. In multivariate analysis, HbA1c (HR = 1.69 [1.10-2.63] per 0.5% decrease; p = .02), DKK1 (HR = 1.28 [1.01-1.61] per 10 ng/mL increase; p = .04), and hypercalcaemia (HR = 2.83 [1.10-7.30]; p = .03) were independently associated with poorer survival. In the subgroup of patients with DEXA, sarcopenia was also associated with poorer survival (HR = 2.96, 95%CI [1.40-6.27]; p = .005). CONCLUSIONS In patients with lung adenocarcinoma and synchronous bone metastases, bone, sarcopenia, and metabolic parameters were predictors of poor overall survival independently of common prognostic factors. We suggest that, in addition to oncological therapy, supportive treatment dedicated to bone metastases, muscle wasting, and energy metabolism are essential to improve prognosis.
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Affiliation(s)
- Lauriane Chambard
- INSERM UMR1033-LYOS, Université de Lyon, Lyon F-69003, France; Rheumatology Department, Hospices Civils de Lyon, Pierre-Bénite F-69495, France.
| | - Nicolas Girard
- Respiratory Medicine Department, Hospices Civils de Lyon, Bron F-69500, France.
| | - Edouard Ollier
- Université Claude Bernard Lyon 1, Villeurbanne F-69100, France
| | | | | | | | - Marie Brevet
- Pathology Department, Hospices Civils de Lyon, Bron F-69500, France.
| | - Pawel Szulc
- INSERM UMR1033-LYOS, Université de Lyon, Lyon F-69003, France.
| | - Jean-Baptiste Pialat
- INSERM UMR1033-LYOS, Université de Lyon, Lyon F-69003, France; Radiology Department, Hospices Civils de Lyon, Pierre-Bénite F-69495, France.
| | - Julien Wegrzyn
- INSERM UMR1033-LYOS, Université de Lyon, Lyon F-69003, France; Orthopedic Department, Hospices Civils de Lyon, Lyon F-69003, France.
| | | | - Cyrille B Confavreux
- INSERM UMR1033-LYOS, Université de Lyon, Lyon F-69003, France; Rheumatology Department, Hospices Civils de Lyon, Pierre-Bénite F-69495, France.
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14
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Menshawy A, Mattar O, Abdulkarim A, Kasem S, Nasreldin N, Menshawy E, Mohammed S, Abdel-Maboud M, Gadelkarim M, El Ashal GG, Elgebaly AS. Denosumab versus bisphosphonates in patients with advanced cancers-related bone metastasis: systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2018; 26:1029-1038. [PMID: 29387997 DOI: 10.1007/s00520-018-4060-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/22/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bone metastasis is reported to be associated with poor quality of life, and increased risk of hospitalization. We aim to synthesize evidence from published randomized controlled trials (RCTs) which compared the efficacy of denosumab versus bisphosphonates in patients with advanced cancers. METHODS We searched for all published RCTs in the following electronic databases: PubMed, Scopus, Web of Science, and Cochrane Central. Retrieved records were screened for eligibility. Time-to-event data were pooled as hazard ratio (HR) using the generic inverse-variance method and dichotomous data were pooled as relative risk (RR) in a random-effect model. We used Review Manager 5.3 for windows. RESULTS Six unique RCTs with a total of 7722 patients were included. Overall effect estimates favored denosumab group in comparison to intravenous (IV) bisphosphonates in the following terms: time to first skeletal-related events (HR 0.92, 95% CI [0.86, 0.98], p = 0.01), time to subsequent skeletal-related event (RR 0.92, 95% CI [0.86, 0.99], p = 0.03), and radiation to bone (RR 0.81, 95% CI [0.71, 0.92], p = 0.02). Denosumab group was associated with increased risk of grade 3 or 4 hypocalcaemia (RR 1.99, 95% CI [1.11, 3.54], p = 0.02) and reduced risk of renal impairment or toxicity (RR 0.75, 95% CI [0.61, 0.91], p = 0.003) in comparison to IV bisphosphonates group. Pooled studies were homogenous. CONCLUSION Denosumab showed a favorable significant impact on delaying the time to first skeletal-related event and reducing the incidence of radiation to the bone event in comparison to bisphosphonates, with similar efficacy regarding overall survival and time to disease progression. Further large-scale and long-term studies are needed to clarify the long-term efficacy and safety of both regimens.
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Affiliation(s)
- Amr Menshawy
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Al-Azhar Medical Students' Association (AMSA), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Omar Mattar
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Ali Abdulkarim
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Shiref Kasem
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Al-Azhar Medical Students' Association (AMSA), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Noha Nasreldin
- Medical Research Society, Cairo University, Cairo, Egypt.,Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Esraa Menshawy
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Salahuddean Mohammed
- Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Mohamed Abdel-Maboud
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Al-Azhar Medical Students' Association (AMSA), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Mohamed Gadelkarim
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Gehad Gamal El Ashal
- Medical Research Education and Practice Association (MREP), Cairo, Egypt.,Medical Research Society, Cairo University, Cairo, Egypt.,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt
| | - Ahmed Saber Elgebaly
- Medical Research Education and Practice Association (MREP), Cairo, Egypt. .,Al-Azhar Medical Students' Association (AMSA), Cairo, Egypt. .,Medical Research Society, Cairo University, Cairo, Egypt. .,Faculty of Medicine, Al-Azhar University, Madinet Nasr, Abbassia, Cairo, 11651, Egypt. .,, Fifteen May City, Egypt.
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15
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Wu ZQ, Chen XT, Xu YY, Tian MJ, Chen HY, Zhou GP, Xu HG. High uric acid (UA) downregulates bone alkaline phosphatase (BALP) expression through inhibition of its promoter activity. Oncotarget 2017; 8:85670-85679. [PMID: 29156749 PMCID: PMC5689639 DOI: 10.18632/oncotarget.21110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/03/2017] [Indexed: 01/15/2023] Open
Abstract
Bone metastases often occur in prostate cancers, lung cancers and breast cancers. Bone alkaline phosphatase (BALP) is one of the most commonly used serological markers for clinical evaluation of bone metabolism. Here, we reported that high concentrations of uric acid (UA) caused decrease of BALP levels and revealed that the effect of high concentrations of UA on the BALP expression was through inhibition of its promoter activity. Our results suggested physicians to think about serum UA status of patients with advanced cancer to avoid misdiagnosis when BALP was used to diagnose or assess the extent of bone metastases.
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Affiliation(s)
- Zhi-Qi Wu
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Xiao-Ting Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Yan-Yan Xu
- Department of Pediatrics, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Ming-Jie Tian
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Hai-Yan Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Guo-Ping Zhou
- Department of Pediatrics, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
| | - Hua-Guo Xu
- Department of Laboratory Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
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16
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Wang R, Zhang S, Jiang Z, Tian J, Wang T, Song S. Bone metabolism markers: Indicators of loading dose intravenous ibandronate treatment for bone metastases from breast cancer. Clin Exp Pharmacol Physiol 2017; 44:88-93. [PMID: 27716993 DOI: 10.1111/1440-1681.12673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 11/27/2022]
Abstract
To investigate the changes in bone metabolism markers after second-line treatment with loading dose intravenous (i.v.) ibandronate in patients with bone metastases (BM) from breast cancer, 80 patients were enrolled in this study during January 2010 to April 2014. All the patients were treated with a second-line loading dose ibandronate for advanced breast cancer with BM and moderate-to-severe bone pain. Ibandronate (6 mg) was intravenously administered on three consecutive days followed by maintenance treatment every 3-4 weeks. Clinical data, including pain score, Karnofsky performance status (KPS) score, and changes in bone metabolism markers, were analyzed. Sixty-two patients were included in the final analysis. Compared with their pre-treatment scores, patients exhibited significantly increased KPS scores (P < .01) and a reduced dose of analgesic medication (oxycodone) (P < .01) after 3 and 6 weeks' post-treatment. The levels of serum bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRACP-5b), and cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) were significantly reduced after 3 and 6 weeks' post-treatment (P < .001). Aside from a few adverse events, no liver or renal toxicity was observed. Bone metabolism markers decreased by varying degrees after treatment with a loading dose of ibandronate in patients with BM from breast cancer. It might be convenient using bone metabolism markers to potentially evaluate the efficacy of bisphosphonates treatment for bone metastasis.
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Affiliation(s)
- Ruliang Wang
- Department of Oncology, The First Affiliated Hospital of PLA General Hospital, Beijing, China
| | - Shaohua Zhang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Zefei Jiang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Jizheng Tian
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Tao Wang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Santai Song
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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17
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D'Oronzo S, Brown J, Coleman R. The role of biomarkers in the management of bone-homing malignancies. J Bone Oncol 2017; 9:1-9. [PMID: 28948139 PMCID: PMC5602513 DOI: 10.1016/j.jbo.2017.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 12/19/2022] Open
Abstract
Bone represents a common site of metastasis from several solid tumours, including breast, prostate and lung malignancies. The onset of bone metastases (BM) is associated not only with serious skeletal complications, but also shortened overall survival, owing to the lack of curative treatment options for late-stage cancer. Despite the diagnostic advances, BM detection often occurs in the symptomatic stage, underlining the need for novel strategies aimed at the early identification of high-risk patients. To this purpose, both bone turnover and tumour-derived markers are being investigated for their potential diagnostic, prognostic and predictive roles. In this review, we summarize the pathogenesis of BM in breast, prostate and lung tumours, while exploring the current research focused on the identification and clinical validation of BM biomarkers.
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Key Words
- 1CTP, cross-linked carboxy-terminal telopeptide of type 1 collagen
- BALP, bone specific alkaline phosphatase
- BC, breast cancer
- BM, bone metastases
- BMDC, bone marrow derived cells
- BMPs, bone morphogenetic proteins
- BSP, bone sialoprotein
- BTA, bone-targeting agents
- BTM, bone turnover markers
- Biomarkers
- Bone metastasis
- Bone turnover markers
- Breast cancer
- CAPG, macrophage-capping protein
- CCL2, chemokine C-C ligand 2
- CTC, circulating tumour cells
- CXCL, C–X–C motif chemokine ligand
- CXCR, C–X–C motif chemokine receptor
- CaSR, calcium sensing receptor
- DPD, deoxypyridinoline
- DTC, disseminated tumour cells
- EMT, epithelial to mesenchymal transition
- ER, estrogen receptor
- FGF, fibroblast growth factor
- GIPC1, PDZ domain–containing protein member 1
- HR, hormone receptor
- Her2, human epidermal growth factor receptor 2
- IGF, insulin-like growth factor
- IL, interleukin
- IL-1R, IL-1 receptor
- LC, lung cancer
- Lung cancer
- M-CSF, macrophage colony stimulating factor
- MAF, v-maf avian musculo-aponeurotic fibrosarcoma oncogene homolog
- NSCLC, non-small cell LC
- NTX and CTX, N- and C- telopeptides of type 1 collagen
- OPG, osteoprotegerin
- P1NP and P1CP, N and C terminal pro-peptides of type 1 collagen
- PC, prostate cancer
- PDGF, platelet-derived growth factor
- PDGFRα, PDGF receptor α
- PSA, prostate specific antigen
- PTH, parathyroid hormone
- PTH-rP, PTH related protein
- PYD, pyridinoline
- PlGF, placental growth factor
- Prostate cancer
- RANK, receptor activator of nuclear factor kB
- RANK-L, RANK-ligand
- SDF-1, stromal cell-derived factor 1
- SREs, skeletal related events
- TGF-β, transforming growth factor-β
- TNF, tumour necrosis factor
- TRACP-5b, tartrate-resistant acid phosphatase type 5b
- TRAF3, TNF receptor associated factor 3
- VEGF, vascular endothelial growth factor
- ZNF217, zinc-finger protein 217
- miRNA, micro RNA
- sBALP, serum BALP
- shRNA, short hairpin RNA
- uNTX, urinary NTX
- β-CTX, CTX β isomer
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Affiliation(s)
- Stella D'Oronzo
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Whitham Road, Sheffield S10 2S, England, UK
| | - Janet Brown
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Whitham Road, Sheffield S10 2S, England, UK
| | - Robert Coleman
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Whitham Road, Sheffield S10 2S, England, UK
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18
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A meta-analysis survey of appropriate bone turnover markers in the detection of bone metastasis in lung cancer. Int J Clin Oncol 2017; 22:1015-1025. [PMID: 28677013 DOI: 10.1007/s10147-017-1159-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/24/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND A number of studies have investigated the clinical significance of bone turnover markers (BTMs) for the diagnosis of bone metastasis (BM) in lung cancer; however, they led to contradictory results. The aim of this meta-analysis was to investigate whether BTMs differ between lung cancer patients with and without BM. METHODS Articles were identified by searching Medline, Embase, Web of Science and Scopus. The studies that were identified were pooled and the weighted mean difference (WMD) and its corresponding 95% confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted. RESULTS A final analysis of 1720 subjects (707 patients with BM and 1013 patients without BM) was performed from 16 cohort studies. From the pooled data in the meta-analysis, the total alkaline phosphatase (TALP) (104.35 U/l [95% CI 33.36-175.34]), bone-specific ALP (BALP) (13.24 μg/l [95% CI 8.50-17.98] or 6.84 U/l [95% CI 2.98-10.70]), C-terminal cross-linked telopeptide of type I collagen (ICTP) (5.07 μg/l [95% CI 3.58-6.56]) and N-terminal cross-linked telopeptide of type I collagen (NTX) (5.08 nM bone collagen equivalent/l [95% CI 2.82-7.33]) were significantly lower among BM patients than non-BM patients. Subgroup analyses detected that the serum level of tartrate-resistant acid phosphatase isoform 5b was significantly reduced in Caucasian patients with BM (-0.64 U/l [95% CI -1.02 to -0.25]), while increased in Asian patients with BM (2.69 U/l [95% CI 0.08-5.31]), compared to patients without BM. CONCLUSIONS The present meta-analysis suggested that serum measurement of TALP, BALP, ICTP and NTX might be helpful in detecting BM in lung cancer.
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D'Oronzo S, Brown J, Coleman R. The value of biomarkers in bone metastasis. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12725] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Stella D'Oronzo
- Academic Unit of Clinical Oncology; Weston Park Hospital; University of Sheffield; Sheffield UK
| | - Janet Brown
- Academic Unit of Clinical Oncology; Weston Park Hospital; University of Sheffield; Sheffield UK
| | - Robert Coleman
- Academic Unit of Clinical Oncology; Weston Park Hospital; University of Sheffield; Sheffield UK
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20
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Shehata AS, Amer MG, Abd El-Haleem MR, Karam RA. The ability of hesperidin compared to that of insulin for preventing osteoporosis induced by type I diabetes in young male albino rats: A histological and biochemical study. ACTA ACUST UNITED AC 2017; 69:203-212. [DOI: 10.1016/j.etp.2017.01.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 01/12/2017] [Accepted: 01/20/2017] [Indexed: 11/28/2022]
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Ferreira ECS, Bortolin RH, Freire-Neto FP, Souza KSC, Bezerra JF, Ururahy MAG, Ramos AMO, Himelfarb ST, Abreu BJ, Didone TVN, Pedrosa LFC, Medeiros AC, Doi SQ, Brandão-Neto J, Hirata RDC, Rezende LA, Almeida MG, Hirata MH, Rezende AA. Zinc supplementation reduces RANKL/OPG ratio and prevents bone architecture alterations in ovariectomized and type 1 diabetic rats. Nutr Res 2017; 40:48-56. [PMID: 28473060 DOI: 10.1016/j.nutres.2017.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/16/2017] [Accepted: 03/09/2017] [Indexed: 02/05/2023]
Abstract
Type 1 diabetes mellitus (T1DM) and estrogen deficiency are associated with several alterations in bone turnover. Zinc (Zn) is required for growth, development, and overall health. Zinc has been used in complementary therapy against bone loss in several diseases. We hypothesized that Zn supplementation represents a potential therapy against severe bone loss induced by the combined effect of estrogen deficiency and T1DM. We evaluated the protective effect of Zn against bone alterations in a chronic model of these disorders. Female Wistar rats were ramdomized into 3 groups (5 rats each): control, OVX/T1DM (ovariectomized rats with streptozotocin-induced T1DM), and OVX/T1DM+Zn (OVX/T1DM plus daily Zn supplementation). Serum biochemical, bone histomorphometric, and molecular analyses were performed. Histomorphometric parameters were similar between the control and OVX/T1DM+Zn groups, suggesting that Zn prevents bone architecture alterations. In contrast, the OVX/T1DM group showed significantly lower trabecular width and bone area as well as greater trabecular separation than the control. The OVX/T1DM and OVX/T1DM+Zn groups had significantly higher serum alkaline phosphatase activity than the control. The supplemented group had higher levels of serum-ionized calcium and phosphorus than the nonsupplemented group. The RANKL/OPG ratio was similar between the control and OVX/T1DM+Zn groups, whereas it was higher in the OVX/T1DM group. In conclusion, Zn supplementation prevents bone alteration in chronic OVX/T1DM rats, as demonstrated by the reduced RANKL/OPG ratio and preservation of bone architecture. The findings may represent a novel therapeutic approach to preventing OVX/T1DM-induced bone alterations.
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Affiliation(s)
- Elaine C S Ferreira
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Raul H Bortolin
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Francisco P Freire-Neto
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Karla S C Souza
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - João F Bezerra
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Marcela A G Ururahy
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana M O Ramos
- Department of Clinical Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Silvia T Himelfarb
- School of Pharmaceutical Science, University of São Paulo, São Paulo, Brazil
| | - Bento J Abreu
- Department of Morphology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Thiago V N Didone
- School of Pharmaceutical Science, University of São Paulo, São Paulo, Brazil
| | - Lucia F C Pedrosa
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Aldo C Medeiros
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sonia Q Doi
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - José Brandão-Neto
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Rosário D C Hirata
- School of Pharmaceutical Science, University of São Paulo, São Paulo, Brazil
| | - Luciana A Rezende
- Department of Chemistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Maria G Almeida
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mario H Hirata
- School of Pharmaceutical Science, University of São Paulo, São Paulo, Brazil
| | - Adriana A Rezende
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Abstract
Biochemical markers of bone turnover (BTM) are released during bone remodeling and can be measured in blood or urine as noninvasive surrogate markers for the bone remodeling rate. The C-terminal cross-linked telopeptide of type I collagen (βCTX) is released during bone resorption and is specific to bone tissue. Assays have been developed to measure βCTX in blood and in urine; most current use of βCTX measurement for research and in clinical practice is performed on a blood sample. Method-specific differences for serum and plasma βCTX have led to initiatives to standardize or harmonize βCTX commercial assays. βCTX demonstrates significant biological variation due to circadian rhythm and effect of food which can be minimized by standardized sample collection in the fasting state in the morning. While βCTX predicts fracture risk independent of bone mineral density, lack of data has precluded its inclusion in fracture risk calculators. The changes seen in βCTX with antiresorptive therapies have been well characterized and this has led to its widespread use for monitoring therapy in osteoporosis. However, more fracture-based data on appropriate treatment goals for monitoring need to be developed. Evidence is lacking for the use of βCTX in managing "drug holidays" of bisphosphonate treatment in osteoporosis or risk stratifying those at increased risk of developing osteonecrosis of the jaw. βCTX is useful as an adjunct to imaging techniques for the diagnosis of Paget's disease of bone and for monitoring therapy and detecting recurrence. βCTX also shows promise in the management of metastatic bone disease.
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Ibrahim T, Ricci M, Scarpi E, Bongiovanni A, Ricci R, Riva N, Liverani C, De Vita A, La Manna F, Oboldi D, Serra P, Foca F, Cecconetto L, Amadori D, Mercatali L. RANKL: A promising circulating marker for bone metastasis response. Oncol Lett 2016; 12:2970-2975. [PMID: 27698885 DOI: 10.3892/ol.2016.4977] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/20/2016] [Indexed: 01/03/2023] Open
Abstract
Bone metastases are a frequent event in patients with solid tumors. Although great advances have been made in the treatment of these patients, the identification of novel, accurate indicators of bone response would greatly facilitate the clinical management of the disease. The receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) signaling pathway is significantly involved in bone metastasis formation. The main aim of the present study was to evaluate the role of circulating RANK, RANKL and OPG levels in predicting bone response. Marker accuracy was also compared with that of the conventional tumor marker N-terminal telopeptide of type I collagen (NTX). A prospective study was performed on 49 patients with bone metastases from breast, lung and prostate cancer, who were undergoing treatment with zoledronic acid. Patients were monitored for 1 year with blood tests, clinical evaluation and instrumental exams according to the response evaluation criteria of the University of Texas M. D. Anderson Cancer Center (Houston, TX, USA) and the Positron Emission Tomography Response Criteria in Solid Tumors. Circulating RANK/RANKL/OPG transcripts and NTX levels were evaluated by reverse transcription-quantitative polymerase chain reaction and immune enzymatic assay, respectively. The baseline RANKL levels differed significantly between responders and non-responders, whereas no differences in NTX levels were observed between the two groups. Receiver operating characteristic curve evaluation for all markers revealed that RANKL was the most accurate marker, with an area under the curve of 0.74 (95% confidence interval, 0.54-0.93). In addition, RANKL, which is the target of the novel monoclonal antibody denosumab, was the most accurate predictor of bone response in the present series of patients with bone metastases. Thus, the use of RANKL as a marker could potentially improve clinical practice, as current bone response evaluation is still somewhat problematic.
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Affiliation(s)
- Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Marianna Ricci
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Rossana Ricci
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Nada Riva
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Alessandro De Vita
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Federico La Manna
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Devil Oboldi
- Radiology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Patrizia Serra
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Dino Amadori
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I-47014 Meldola, Italy
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Khan AH, Sadroddiny E. Application of immuno-PCR for the detection of early stage cancer. Mol Cell Probes 2016; 30:106-12. [DOI: 10.1016/j.mcp.2016.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 12/11/2022]
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Aiba H, Kimura T, Yamagami T, Watanabe N, Sakurai H, Kimura H, Shimozaki S, Yamada S, Otsuka T. Prediction of skeletal-related events in patients with non-small cell lung cancer. Support Care Cancer 2016; 24:3361-7. [PMID: 26980332 DOI: 10.1007/s00520-016-3167-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/07/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Advanced lung cancer frequently causes bone metastasis which can be associated with skeletal-related events (SREs) that may cause significant deterioration of the patient's quality of life (QoL). The Spinal Instability Neoplastic Score (SINS) can be used to assist in standardizing evaluations of neoplastic spinal instability between spinal and non-spine surgeons. This research investigated the association between SREs and SINS for patients with non-small cell lung cancer (NSCLC). METHODS Between 2009 and 2013, 47 patients with NSCLC who were diagnosed with bone metastasis were classified using SINS into either a stable group (SINS, 0-6 points) or unstable group (SINS, 7-18 points). The primary endpoint was time from diagnosis of metastasis to SREs. Secondary endpoints included tumor type and epidermal growth factor receptor (EGFR) mutational status. SREs were defined as spinal compression, pathologic fracture, spinal surgery, and hypercalcemia. RESULTS Patients included 37 cases of adenocarcinoma and 10 cases of squamous cell carcinoma. Mean follow-up time was 10.2 ± 13.7 months. SRE incidence was 15.0 % (3/20) in the stable group versus 44.4 % (12/27) in the unstable group (p = 0.048). A Cox regression model revealed that an EGFR-positive mutational status (hazard ratio [HR] = 0.15, 95 % CI, 0.030.71; p = 0.017) or good spinal stability (HR = 0.49; 0.08-0.99; p = 0.049) were favorable prognostic factors. CONCLUSION The incidence of SREs was significantly lower in NSCLC patients with better spinal stability as determined by SINS, which was a good prediction tool for SREs from bone metastasis. The lower incidence of SREs in EGFR-positive patients suggests tumor biology should be considered when predicting SREs.
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Affiliation(s)
- Hisaki Aiba
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Azakawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi pref, 467-8601, Japan. .,Department of Orthopaedic Surgery, Tosei General Hospital, 160, Nishioiwake-cho, Seto City, Aichi pref, 489-8642, Japan.
| | - Tomoki Kimura
- Division of Respiratory Medicine and Allergology, Department of Medicine, Tosei General Hospital, 160, Nishioiwake-cho, Seto City, Aichi pref, 489-8642, Japan
| | - Takaya Yamagami
- Department of Orthopaedic Surgery, Tosei General Hospital, 160, Nishioiwake-cho, Seto City, Aichi pref, 489-8642, Japan
| | - Nobuyuki Watanabe
- Department of Orthopaedic Surgery, Tosei General Hospital, 160, Nishioiwake-cho, Seto City, Aichi pref, 489-8642, Japan
| | - Hironari Sakurai
- Department of Orthopaedic Surgery, Tosei General Hospital, 160, Nishioiwake-cho, Seto City, Aichi pref, 489-8642, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Azakawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi pref, 467-8601, Japan
| | - Shingo Shimozaki
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Azakawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi pref, 467-8601, Japan
| | - Satoshi Yamada
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Azakawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi pref, 467-8601, Japan
| | - Takanobu Otsuka
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Azakawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi pref, 467-8601, Japan
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Hong BY, Ibrahim MFK, Fernandes R, Mazzarello S, Hutton B, Shorr R, Clemons M. De-escalation of bone-targeted agents for metastatic prostate cancer. ACTA ACUST UNITED AC 2016; 23:e77-8. [PMID: 26966418 DOI: 10.3747/co.23.2913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite advances in therapy, bone remains the most common site of prostate cancer recurrence [...]
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Affiliation(s)
- Brian Younho Hong
- MD program, Faculty of Medicine University of Ottawa, Ottawa, Ontario
| | - Mohammed F K Ibrahim
- Division of Medical Oncology and Department of Medicine, University of Ottawa Ottawa, Ontario
| | - Ricardo Fernandes
- Division of Medical Oncology and Department of Medicine, University of Ottawa Ottawa, Ontario
| | | | - Brian Hutton
- Department of Epidemiology and Community Medicine University of Ottawa and Ottawa Hospital Research Institute Ottawa, Ontario
| | | | - Mark Clemons
- Division of Medical Oncology and Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute Ottawa, Ontario
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Nilsson S. Radionuclide Therapies in Prostate Cancer: Integrating Radium-223 in the Treatment of Patients With Metastatic Castration-Resistant Prostate Cancer. Curr Oncol Rep 2016; 18:14. [PMID: 26779616 PMCID: PMC4715854 DOI: 10.1007/s11912-015-0495-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Metastatic castration-resistant prostate cancer (mCRPC) frequently metastasizes to the bone, often resulting in painful skeletal events, reduced quality of life, and reduced survival. The beta-emitting radiopharmaceuticals strontium-89 and samarium-153 alleviated pain in mCRPC patients with widespread skeletal metastases and have been associated with myelotoxicity. Radium-223, a first-in-class alpha-emitting radiopharmaceutical, prolonged overall survival, delayed symptomatic skeletal events, and improved quality of life, versus placebo, in patients with CRPC and symptomatic bone metastases and no visceral metastases. Radium-223 provided survival benefit to patients with CRPC and symptomatic bone metastases, regardless of prior docetaxel use. Importantly, prostate-specific antigen level and pain palliation were not a measure of radium-223 treatment response and should not alter the decision to administer all six radium-223 injections, the recommended regimen for survival benefit. Radium-223 was generally well tolerated, leading to ongoing clinical trials in combination with other therapeutics. Thus, radium-223 is a valuable addition to the mCRPC treatment armamentarium.
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Affiliation(s)
- Sten Nilsson
- Department of Oncology-Pathology, Karolinska University Hospital, Karolinska Institutet, SE-17177, Solna, Sweden.
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Abstract
In the context of breast cancer, the importance of the skeleton in the regulation of primary tumour development and as a site for subsequent metastasis is well characterized. Our understanding of the contributions made by the host bone and bone marrow cells increasingly demonstrates the extent of the interaction between tumour cells and normal host cells. As a result, the need to develop and utilize therapies that can impede the growth and/or function of tumour cells while sparing normal host bone and bone marrow cells is immense and expanding. The need for these new treatments is, however, superimposed on the orthopaedic management of patients' quality of life, where pain control and continued locomotion are paramount. Indeed, the majority of the anticancer therapies used to date often result in direct or indirect damage to bone. Thus, although the bone microenvironment regulates tumour cell growth in bone, cells within the bone marrow niche also mediate many of the orthopaedic consequences of tumour progression as well as resistance to the antitumour effects of existing therapies. In this Review, we highlight the effects of existing cancer treatments on bone and the bone marrow microenvironment as well as the mechanisms mediating these effects and the current utility of modern orthopaedic interventions.
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Affiliation(s)
- Issam Makhoul
- Department of Medicine, Division of Haematology/Oncology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Corey O Montgomery
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Dana Gaddy
- Department of Physiology and Biophysics, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Larry J Suva
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
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Zhao QT, Yang ZX, Yang L, Xing D, Wei JC, Li WY. Diagnostic value of bone-specific alkaline phosphatase in lung carcinoma patients with bone metastases: a meta-analysis. Int J Clin Exp Med 2015; 8:17271-17280. [PMID: 26770319 PMCID: PMC4694219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/09/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED Aim and Backgrounds: The accurate diagnosis of lung carcinoma patients with bone metastases is crucial for therapy and the prevention of complications. We performed a systematic review and meta-analysis to evaluate the diagnostic value of serum bone-specific alkaline phosphatase (BALP) in lung carcinoma patients with bone metastases. METHODS Such databases as PubMed, Embase, Cochrane Library, Web of Science, Ovid, BioMed Central, Biosis previews and four Chinese databases (Chinese Biomedical Literature Database-disc (CBM), Chinese National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP) and Wan Fang DATA) were retrieved on computer, and the relevant journals were also manually searched to collect the trials on BALP in diagnosis of lung carcinoma patients with bone metastases. The meta-analysis was conducted by using Meta-Disc 1.4 software. RESULTS A total of 8 studies were included, and there were 848 lung carcinoma patients diagnosed by gold standard, patients were divided into two groups: 419 cases with bone metastases and 429 cases without bone metastases. The meta-analysis showed that, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) was 0.48 [95% CI (0.43 to 0.53)], 0.86 [95% CI (0.82 to 0.89)], 3.14 [95% CI (2.47 to 3.99)], 0.62 [95% CI (0.56 to 0.68)], 6.66 [95% CI (4.62 to 9.60)] respectively. And the AUC of SROC was 0.78, (Q*=0.72). CONCLUSION BALP has greater diagnostic value in detecting lung carcinoma patients with bone metastases. However, further large scale studies are required to confirm the predictive value.
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Affiliation(s)
- Qing-Tao Zhao
- Department of Thoracic Surgery, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Zhao-Xu Yang
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Lei Yang
- Department of Pediatrics, Bethune International Peace Hospital of Chinese PLAShijiazhuang 050082, Hebei, P. R. China
| | - Dong Xing
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Jing-Chao Wei
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
| | - Wen-Yi Li
- Department of Orthopedics, Hebei General HospitalShijiazhuang 050051, Hebei, P. R. China
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30
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Identifying impending pathologic fractures and treatment considerations in patients with metastatic bone disease. CURRENT ORTHOPAEDIC PRACTICE 2015. [DOI: 10.1097/bco.0000000000000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ibrahim MFK, Mazzarello S, Shorr R, Vandermeer L, Jacobs C, Hilton J, Hutton B, Clemons M. Should de-escalation of bone-targeting agents be standard of care for patients with bone metastases from breast cancer? A systematic review and meta-analysis. Ann Oncol 2015; 26:2205-13. [PMID: 26122727 DOI: 10.1093/annonc/mdv284] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/24/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND De-escalation of bone-targeted agents, such as bisphosphonates and denosumab, from 4- to 12-weekly dosing is an increasingly used strategy in patients with bone metastases from breast cancer. It is unclear whether there is sufficient evidence to support de-escalation as a standard of care. METHODS A systematic review of randomized trials comparing standard 4-weekly administration of bone-targeted agents with de-escalated (Q12-weekly) dosing in breast cancer patients was carried out. Medline, PubMed and the Cochrane Register of Controlled Trials were searched from inception until November 2014 for relevant studies. Outcomes of interest included skeletal-related event (SRE) rates, bone pain, adverse events (AEs) and bone turnover biomarkers. Random-effects meta-analyses were carried out. RESULTS A total of nine citations representing seven unique studies were eligible. One study is ongoing with no reported data. Six studies reported data for at least one outcome of interest. Data were available comparing standard versus de-escalated therapy for pamidronate (1 study, 38 patients), zoledronate (3 studies, 1117 patients) and denosumab (2 studies, 284 patients). Meta-analysis of five trials reporting data for on-study SRE rates between standard (61/443 patients) and de-escalated (49/392 patients) arms produced a summary risk ratio of 0.90 (95% confidence interval 0.63-1.29). Meta-analyses of data for AEs and bone turnover biomarkers also showed no statistically significant differences between standard and de-escalated arms, though only limited numbers of patients and events were present for most analyses. CONCLUSION In this systematic review of studies of bisphosphonates and denosumab, there appears to be no difference in SREs or pain with de-escalated therapy. While a large, hopefully definitive study is ongoing, the data presented so far are consistent with de-escalation of bone-targeting agents becoming a standard of care for patients with bone metastases from breast cancer.
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Affiliation(s)
- M F K Ibrahim
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital
| | - S Mazzarello
- Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa
| | - R Shorr
- The Ottawa General Hospital, Ottawa, Canada
| | - L Vandermeer
- Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa
| | - C Jacobs
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital
| | - J Hilton
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa
| | - B Hutton
- Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa
| | - M Clemons
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa
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Chow E, DeAngelis C, Chen BE, Azad A, Meyer RM, Wilson C, Kerba M, Bezjak A, Wilson P, Nabid A, Greenland J, Rees G, Vieth R, Wong RK, Hoskin P. Effect of re-irradiation for painful bone metastases on urinary markers of osteoclast activity (NCIC CTG SC.20U). Radiother Oncol 2015; 115:141-8. [DOI: 10.1016/j.radonc.2015.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 11/16/2022]
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Kolokythas A, Karras M, Collins E, Flick W, Miloro M, Adami G. Salivary Biomarkers Associated With Bone Deterioration in Patients With Medication-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg 2015; 73:1741-7. [PMID: 25889372 DOI: 10.1016/j.joms.2015.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 03/06/2015] [Accepted: 03/09/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to investigate the use of saliva as a medium for the identification of biomarkers associated with bone resorption and formation. The authors hypothesized that biomarkers, such as N-telopeptide of type I collagen (NTX) and bone-specific alkaline phosphatase (B-AP), could be identified in saliva. They further hypothesized that there would be a difference between these biomarkers in the saliva of patients with medication-relation osteonecrosis of the jaws (MRONJ) and those who have no risk factors for the development of MRONJ. PATIENTS AND METHODS This case-and-control study compared 2 salivary biomarkers, NTX and B-AP, in a group of patients with MRONJ and a control group. The predictor variable was the presence or absence of the disease (MRONJ or control group); the outcome variables were the levels of the 2 salivary biomarkers, NTX and B-AP. Saliva samples from 20 patients with a diagnosis of MRONJ and 14 control participants who were comparable to the study group with no history of antiresorptive medication use were collected. The saliva samples were analyzed using 2 commercially available assays for NTX and B-AP to evaluate for levels of each marker. A 2-tailed t test for 2 groups of unequal distribution was used for statistical analysis, with P values less than .05 considered statistically. RESULTS The 2 biomarkers, NTX and B-AP, were detected in saliva samples from the MRONJ and control groups. A statistically significant difference was found in the levels of NTX in saliva of patients with MRONJ compared with the control participants (P = .0067). CONCLUSIONS In this exploratory study, the 2 bone deterioration biomarkers (NTX and B-AP) were detected in saliva. There was a statistical difference in the levels of salivary NTX between patients with MRONJ and controls. Saliva evaluation could provide a novel method to detect, diagnose, stage, and potentially guide treatment decisions and monitor outcomes for patients with MRONJ in the future.
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Affiliation(s)
- Antonia Kolokythas
- Associate Professor, Program Director, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL.
| | - Maria Karras
- Dental Student, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL
| | - Edward Collins
- Former Chief Resident, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL
| | - William Flick
- Clinical Professor, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL
| | - Michael Miloro
- Professor and Head, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL
| | - Guy Adami
- Associate Professor, Department of Oral Medicine and Diagnostic Sciences, University of Illinois at Chicago, College of Dentistry and the University of Illinois Hospitals and Health Science Center, Chicago, IL
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Mylin AK, Abildgaard N, Johansen JS, Heickendorff L, Kreiner S, Waage A, Turesson I, Gimsing P. Serum YKL-40: a new independent prognostic marker for skeletal complications in patients with multiple myeloma. Leuk Lymphoma 2015; 56:2650-9. [PMID: 25573204 DOI: 10.3109/10428194.2015.1004168] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In a time of increasing treatment options for multiple myeloma bone disease, risk factors predicting progression need to be elucidated. This study investigated the value of serum YKL-40, previously shown to be associated with radiographic progression of bone destruction, as a predictor for time to clinical progression, i.e. skeletal-related events (SREs), in 230 newly diagnosed patients with multiple myeloma receiving intravenous bisphosphonates. Serum concentrations of YKL-40 and biochemical bone markers (CTX-MMP, CTX-I, PINP) were measured at diagnosis. Patients were evaluated every third month for SRE and at 9 and 24 months for radiographic progression. Elevated serum YKL-40 was seen in 47% of patients and associated with high-risk disease (International Staging System stage III; p < 0.001), increased bone resorption (serum CTX/MMP; p < 0.001) and early radiographic progression at 9 months (p = 0.01). Serum YKL-40 together with serum CTX-MMP/PINP ratio and World Health Organization status were independent predictors of time to first SRE.
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Affiliation(s)
- Anne K Mylin
- a Department of Hematology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark
| | - Niels Abildgaard
- b Department of Hematology , Odense University Hospital , Odense , Denmark
| | - Julia S Johansen
- c Departments of Medicine and Oncology , Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Lene Heickendorff
- d Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark
| | - Svend Kreiner
- e Department of Biostatistics , University of Copenhagen , Copenhagen , Denmark
| | - Anders Waage
- f Department of Hematology , St Olav Hospital, Norwegian University of Science and Technology , Trondheim , Norway
| | - Ingemar Turesson
- g Department of Hematology , Skane University Hospital , Malmö , Sweden
| | - Peter Gimsing
- a Department of Hematology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark
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Barnadas A, Manso L, de la Piedra C, Meseguer C, Crespo C, Gómez P, Calvo L, Martinez P, Ruiz-Borrego M, Perelló A, Antón A, Codes M, Margelí M, Murias A, Salvador J, Seguí MÁ, de Juan A, Gavilá J, Luque M, Pérez D, Zamora P, Arizcuma A, Chacón JI, Heras L, Martin-Fernández M, Mahillo-Fernández I, Tusquets I. Bone turnover markers as predictive indicators of outcome in patients with breast cancer and bone metastases treated with bisphosphonates: results from a 2-year multicentre observational study (ZOMAR study). Bone 2014; 68:32-40. [PMID: 25108081 DOI: 10.1016/j.bone.2014.07.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 07/15/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND We evaluated the evolution and predictive value of bone turnover markers (BTMs) and circulating tumor cells (CTCs) with respect to mortality, disease progression (DP) and skeletal-related events (SREs), in patients with bone metastatic breast cancer (BmBCa). The correlation between BTMs and CTCs was also studied. METHODS In a 2-year observational, multicenter study, the levels of three BTMs (N- and C-terminal telopeptides of collagen I [NTX and αα-CTX], and bone-specific alkaline phosphatase [BSAP]) and CTCs were analyzed every three months. Patients received zoledronic acid (4mg every 28days) from the baseline visit. RESULTS 234 patients were analyzed. The levels of the BTMs were increased at baseline and significantly decreased after 3months (P<0.05). In the Cox regression univariate analyses significant hazard ratios (HRs) for death were found for pathological BSAP values at baseline (5.03 [95% CI: 1.214-20.839; P=0.0259]) and at 3months (3.41 [95% CI: 1.367-8.498; P=0.0085]). HRs >2 were found for increased baseline and 3-month levels of NTX and CTC (P<0.05). Only increased baseline BSAP levels were associated with DP (HR=2.25 [95% CI: 1.391-3.626; P=0.0009]). No biomarker was associated with SREs. In the multivariate analysis, pathologic levels at 3months of NTX and BSAP were significantly associated with mortality (HRs=3.59 [95% CI: 1.375-9.382; P=0.0091] and 3.25 [95% CI: 1.293-8.189; P=0.0120], respectively). CTC and BSAP were correlated during all study timepoints (P<0.05). CONCLUSIONS Baseline levels of NTX, BSAP and CTCs, and changes after treatment initiation with bisphosphonates, may be useful for the prognostic assessment of patients with BmBCa. BSAP showed the strongest prognostic value.
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Affiliation(s)
- Agustí Barnadas
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Luis Manso
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041 Madrid, Spain.
| | - Concepción de la Piedra
- Bioquímica Investigación, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Cristina Meseguer
- Medical Department, Novartis Farmacéutica S.A., Gran Via de les Corts Catalanes, 764, 08013 Barcelona, Spain.
| | - Carmen Crespo
- Medical Oncology Department, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9100, 28034 Madrid, Spain.
| | - Patricia Gómez
- Oncology Department, Hospital Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Lourdes Calvo
- Oncology Department, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006 A Coruña, Spain.
| | - Purificación Martinez
- Oncology Department, Hospital Universitario Basurto, Avda. de Montevideo, 18, 48013 Bilbao, Spain.
| | - Manuel Ruiz-Borrego
- Oncology Department, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, 0, 41013 Sevilla, Spain.
| | - Antonia Perelló
- Medical Oncology Service, Hospital Universitari Son Dureta, Andrea Doria, 55, 07014 Palma de Mallorca, Spain.
| | - Antonio Antón
- Medical Oncology Department, Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
| | - Manuel Codes
- Medical Oncology Department, Hospital Virgen Macarena, Avda. Dr. Fedriani, 3, 41007 Sevilla, Spain.
| | - Mireia Margelí
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Crta. Canyet, 08916 Badalona, Spain.
| | - Adolfo Murias
- Oncology Department, Hospital Insular de Gran Canaria, Plaza Doctor Pasteur, s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Javier Salvador
- Medical Oncology Department, Hospital Universitario Nuestra Señora de Valme, Avda. de Bellavista, s/n, 41014 Sevilla, Spain.
| | - Miguel Ángel Seguí
- Medical Oncology Department, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Spain.
| | - Ana de Juan
- Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla, s/n, 39008 Santander, Spain.
| | - Joaquín Gavilá
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Profesor Beltrán Bàguena, 8, 46009 Valencia, Spain.
| | - María Luque
- Medical Oncology Department, Hospital Universitario Central de Asturias, Celestino Villamil, s/n, 33006 Oviedo, Spain.
| | - Diego Pérez
- Oncology Department, Hospital Costa del Sol, Autovía A-7, Km. 187, 29603 Marbella, Málaga, Spain.
| | - Pilar Zamora
- Medical Oncology Service, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
| | - Alberto Arizcuma
- Oncology Department, Hospital General Río Carrión, Avda. Donantes de Sangre, s/n, 34005 Palencia, Spain.
| | - José Ignacio Chacón
- Medical Oncology Department, Hospital Virgen de la Salud, Avda. de Barber, 30, 45071 Toledo, Spain.
| | - Lucía Heras
- Oncology Service, Hospital de la Creu Roja, Avinguda Josep Molins, 29-41, 08906 L'Hospitalet de Llobregat, Spain.
| | - Marta Martin-Fernández
- Bioquímica Investigación, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Ignacio Mahillo-Fernández
- Epidemiology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Ignacio Tusquets
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Passeig Marítim de la Barceloneta, 25-29, 08003 Barcelona, Spain.
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Fang J, Xu Q. Differences of osteoblastic bone metastases and osteolytic bone metastases in clinical features and molecular characteristics. Clin Transl Oncol 2014; 17:173-9. [DOI: 10.1007/s12094-014-1247-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/30/2014] [Indexed: 12/12/2022]
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Addison CL, Pond GR, Zhao H, Mazzarello S, Vandermeer L, Goldstein R, Amir E, Clemons M. Effects of de-escalated bisphosphonate therapy on bone turnover biomarkers in breast cancer patients with bone metastases. SPRINGERPLUS 2014; 3:577. [PMID: 25332877 PMCID: PMC4194305 DOI: 10.1186/2193-1801-3-577] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 01/10/2023]
Abstract
While de-escalation of bisphosphonates from 4 to 12-weekly dosing has been shown to be clinically non-inferior to standard dosing, there is evidence the de-escalation is associated with increased bone turnover biomarkers. Here we evaluated the effect of de-escalated dosing on a panel of biomarkers and determined their association with incidence of skeletal related events (SREs) in breast cancer patients with ‘low risk’ bone metastases. As part of a pilot randomized trial, women with baseline C-telopeptide levels <600 ng/L after >3 months of 3–4 weekly pamidronate were randomized to continue pamidronate every 4 weeks or de-escalation to 12-weekly treatment. Serum was analysed for bone biomarkers (C-telopeptide, N-telopeptide, bone-specific alkaline phosphatase, transforming growth factor-β, procollagen type 1 N-propeptide, activinA and bone sialoprotein) using ELISA. The associations between changes in biomarkers, pain scores and SREs were assessed by univariable logistic regression. Numerical increases in all biomarkers were observed between baseline and 12 weeks but were of higher magnitude in the de-escalated arm. Pain scores in the de-escalated treatment arm showed a greater magnitude of pain reduction from baseline to 12 weeks. Neither baseline levels nor changes in biomarkers from baseline to 12 weeks on treatment were associated with on study SREs. Baseline pain as measured by the FACT-BP was associated with increased risk of SRE. In conclusion, biomarkers of bone activity do not appear to predict for SREs in ‘low risk’ cohorts. However, baseline bone pain appears to be associated with SRE occurrence, a finding which warrants evaluation in larger cohorts.
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Affiliation(s)
- Christina L Addison
- Program for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON Canada ; Department of Medicine, University of Ottawa, Ottawa, ON Canada ; Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON Canada
| | - Gregory R Pond
- Department of Oncology, McMaster University, Hamilton, Canada
| | - Huijun Zhao
- Program for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Sasha Mazzarello
- Program for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Lisa Vandermeer
- Program for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | | | - Eitan Amir
- Princess Margaret Hospital, Toronto, ON Canada
| | - Mark Clemons
- Program for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON Canada ; Department of Medicine, University of Ottawa, Ottawa, ON Canada
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Jung K, Lein M. Bone turnover markers in serum and urine as diagnostic, prognostic and monitoring biomarkers of bone metastasis. Biochim Biophys Acta Rev Cancer 2014; 1846:425-38. [PMID: 25220832 DOI: 10.1016/j.bbcan.2014.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/14/2014] [Accepted: 09/01/2014] [Indexed: 01/25/2023]
Abstract
Bone metastases are characterized by increased osteoblastic and/or osteolytic processes depending on the tumor type. The altogether destructive effect of metastasis formation promoted by increased metabolic activity raises the release of components from the osseous metabolism into the blood stream. These components are either enzymes directly involved in the alteration processes, metabolites/proteins that develop during this or bone matrix proteins released during this. These biomarkers are categorized in relation to their involvement in the bone formation or resorption as bone formation and resorption markers. Based on a PubMed literature search, a critical appraisal of the various biomarkers for diagnostic, prognostic, and monitoring purposes is given for patients with skeletal metastases caused by breast, prostate, lung, or renal cell carcinomas.
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Affiliation(s)
- Klaus Jung
- Department of Urology, University Hospital Charité, Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany.
| | - Michael Lein
- Berlin Institute for Urologic Research, Berlin, Germany; Department of Urology, Sana Hospital Center, Offenbach, Germany
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Endo T, Kamiya N, Suzuki H, Oka R, Lee FC, Utsumi T, Yano M, Kamijima S, Kawamura K, Imamoto T, Ichikawa T. Bone markers predict survival in castration-resistant prostate cancer patients treated with docetaxel. World J Clin Urol 2014; 3:139-143. [DOI: 10.5410/wjcu.v3.i2.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/11/2014] [Accepted: 06/18/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the relationship between clinicopathological features and bone turnover markers in castration-resistant prostate cancer (CRPC) patients treated with docetaxel.
METHODS: Thirty-three patients were enrolled in this study. Serum levels of carboxyterminal cross-linked telopeptide of type 1 collagen generated by metalloproteinases (1CTP) and alkaline phosphatase (ALP) were measured at the start of docetaxel chemotherapy. We examined the relationship between clinicopathological features and serum levels of 1CTP and ALP levels in CRPC patients treated with docetaxel.
RESULTS: For the total patient group, the mean ± standard deviation (SD) values for docetaxel chemotherapy dose, dose intensity, dosage interval, and number of cycles were 59.3 ± 10.6 mg/m2, 13.9 ± 5.2 mg/m2 per week, 4.7 ± 1.2 wk, and 11.2 ± 7.4, respectively. Fourteen patients died from prostate cancer. Patients were divided into two groups according to mean + SD of serum 1CTP (8.2 ng/mL) and ALP (538.2 IU/L) levels at the start of docetaxel chemotherapy. Patients with lower levels of serum 1CTP and ALP had significantly better survivals than those with higher serum levels (P < 0.05).
CONCLUSION: Serum levels of 1CTP and ALP are predictors of survival in patients with CRPC who are treated with docetaxel.
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Abstract
The synthesis rates of fibrillar collagens can be assessed in blood by measuring propeptides set free from corresponding procollagens before fiber formation. Type I collagen is the major component of the organic matrix of bone, but it is also found in other connective tissues. The serum concentration of the amino-terminal propeptide of type I procollagen, PINP, functions as a measure of type I collagen synthesis during normal bone turnover, but it is also released from bone metastases that involve an osteoblastic component. Type III collagen is a major constituent of soft tissues and the corresponding amino-terminal propeptide, PIIINP, reflects collagen synthesis. Circulating PIIINP tends to be affected by malignomas that grow in the peritoneal cavity or affect bone marrow. Many studies on procollagen markers in cancer have been cross-sectional or demonstrated treatment effects in patient groups. Markers that originate from bone turnover have wide reference intervals, but low biologic variability in individuals. Thus, they appear better suited for monitoring versus diagnostic purposes. There is still definite need for research on the use of procollagen markers in the followup of individual patients undergoing cancer treatment or being monitored after such treatment.
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Tamjidipoor A, Tavafi M, Ahmadvand H. Effect of dimethyl sulfoxide on inhibition of post-ovariectomy osteopenia in rats. Connect Tissue Res 2013; 54:426-31. [PMID: 24020358 DOI: 10.3109/03008207.2013.841678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There is increasing evidence that oxidative stress, due to estrogen deficiency, leads to osteopenia. In this study, dimethyl sulfoxide (DMSO), an antioxidant solvent, was used against post-ovariectomy osteopenia (PO) in rats. Forty female rats were divided into 5 groups randomly as follows: Sham, control group; OVX, ovariectomized group; DMSO1, ovariectomized injected DMSO (0.5 ml/kg/d ip); DMSO2, ovariectomized injected DMSO (1 ml/kg/day ip) and DMSO3, ovariectomized injected DMSO (2 ml/kg/d ip). DMSO therapy started 1 week after ovariectomy and continued for 13 weeks. After 13th weeks, sera were prepared, and then L4 vertebrae and right tibial bones rinsed in fixative. Serum bone alkaline phosphatase (BALP), osteocalcin, pyridinoline, malondialdehyde (MDA) and glutathione (GSH) were measured. Trabecular volume density, trabecular and cortex thickness were estimated. Osteoclast and osteoblast numbers were counted morphometrically. The data were analyzed by ANOVA and then post hoc Tukey test at p < 0.05. The increase of pyridinoline and decrease of BALP in DMSO injected groups were inhibited compared with OVX group (p < 0.05). In DMSO injected groups, decrease of bone density, trabecular volume density, thickness of trabecular and tibial cortex were inhibited compared with OVX group (p < 0.05). MDA decreased significantly in DMSO injected groups compared with OVX group. Osteoclast number decreased in DMSO injected groups compared with OVX group (p < 0.05). Osteoblast number did not show significant change in DMSO groups compared with OVX group. In conclusion, DMSO ameliorates PO through decrease of osteoclast number, osteoclast inhibition and osteoblast activation. These effects may probably be mediated via antioxidant property of DMSO.
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Affiliation(s)
- Ahmad Tamjidipoor
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences , Khorramabad , Iran and
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Bone markers for monitoring efficacy in patients
with bone metastases receiving zoledronic acid:
a review of published data. Int J Biol Markers 2013; 28:242-8. [PMID: 23661577 DOI: 10.5301/jbm.5000022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
Abstract
Bone metastases occur frequently in patients with advanced solid tumors and can create serious clinical problems that are commonly referred to as skeletal-related events. Although bisphosphonates, especially zoledronic acid, have emerged as an integral determinant of managing metastatic bone disease, their application remains a challenge because of the lack of standardized measures and their side effects. Since factors derived from bone metabolism are potentially useful to measure the efficacy of zoledronic acid, several clinical trials have investigated these bone markers with respect to their monitoring values. The results suggest that a greater decline in bone marker levels is associated with a more reduced incidence of skeletal-related events and a better improvement of symptoms. This review summarizes the available evidence on the clinical use of bone markers in monitoring zoledronic acid in various cancers with bone metastases including breast, prostate and lung cancer.
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Tang C, Liu Y, Qin H, Li X, Guo W, Li J, Wang W, Qu L, Hu H, Xu C, Zheng L, Huang Y, Liu B, Gao H, Halleen JM, Liu X. Clinical significance of serum BAP, TRACP 5b and ICTP as bone metabolic markers for bone metastasis screening in lung cancer patients. Clin Chim Acta 2013; 426:102-7. [PMID: 24055775 DOI: 10.1016/j.cca.2013.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/17/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND We investigated the clinical significance of serum bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase isoform 5b (TRACP 5b) and type I collagen carboxyterminal telopeptide (ICTP) as bone metabolic markers for bone metastasis (BM) screening in lung cancer patients. METHODS Newly diagnosed advanced lung cancer patients with (N = 130) and without (N = 135) BM were enrolled in the study. Serum BAP, TRACP 5b and ICTP were measured before the treatment. RESULTS BAP, TRACP 5b and ICTP values were higher in patients with BM compared with patients without BM (all P < 0.0001). Area under ROC curve (AUC) of BAP, TRACP 5b and ICTP was 0.760, 0.753 and 0.835 (all P < 0.0001), respectively. The cut-off values for BAP, TRACP 5b and ICTP were 21.8 μg/l, 7.8 U/l and 8.8 μg/l, respectively. When TRACP 5b and ICTP were combined, AUC was elevated to 0.895 (P < 0.0001), and the cut-off values were TRACP 5b 7.6 U/l and ICTP 8.4 μg/l. CONCLUSIONS We conclude that serum BAP, TRACP 5b and ICTP may serve as useful tools for BM screening in lung cancer patients.
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Affiliation(s)
- Chuanhao Tang
- Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, No. 8 Dongdajie, Beijing 100071, China
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Brufsky AM, Sereika SM, Mathew A, Tomifumi O, Singh V, Rosenzweig M. Long-term treatment with intravenous bisphosphonates in metastatic breast cancer: a retrospective study. Breast J 2013; 19:504-11. [PMID: 23800050 DOI: 10.1111/tbj.12152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bisphosphonates are important therapies used to reduce the risk of skeletal-related events in patients with bone metastases from breast cancer (BC). This retrospective cohort study evaluated the incidence of osteonecrosis of the jaw (ONJ) and renal impairment in women (n = 221) with bone metastases from BC treated with intravenous bisphosphonates from January 1999 to June 2008. In the long-term cohort, 159 patients received pamidronate (n = 9), zoledronic acid (n = 110), or both (n = 40) for ≥24 months. The comparator group consisted of patients treated with intravenous bisphosphonates for 12-23 months (n = 62). After 39 months' median follow-up, six of 159 patients developed ONJ (3.8%; median 38.5 treatment cycles and 44 months' exposure) in the long-term cohort. Of patients who developed ONJ, 50% resumed intravenous bisphosphonates after a 12-month treatment holiday. Renal impairment developed in 19 patients in the long-term cohort (11.9%; median 26 treatment cycles and 26 months' exposure). Of these 19 patients, 11 (57.9%) recovered baseline renal function and seven (36.7%) showed partial recovery. After modification of the intravenous bisphosphonate regimen, 17 of 19 patients (89.4%) resumed therapy. Of the 62 patients in the comparator cohort, one patient developed ONJ (1.6%) and six developed renal impairment (9.7%). Similar incidence rates of ONJ and renal impairment were observed for the long-term and comparator cohorts. Times to ONJ or renal impairment also were similar across intravenous bisphosphonate type. Long-term (≥24 months) intravenous bisphosphonate use in metastatic BC is well tolerated, with low incidences of ONJ and renal impairment.
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Affiliation(s)
- Adam M Brufsky
- Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Mercatali L, Ricci M, Scarpi E, Serra P, Fabbri F, Ricci R, Liverani C, Zanoni M, Zoli W, Maltoni R, Gunelli E, Amadori D, Ibrahim T. RANK/RANK-L/OPG in patients with bone metastases treated with anticancer agents and zoledronic acid: a prospective study. Int J Mol Sci 2013; 14:10683-93. [PMID: 23702841 PMCID: PMC3709696 DOI: 10.3390/ijms140610683] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/09/2013] [Accepted: 05/13/2013] [Indexed: 12/23/2022] Open
Abstract
Patients with solid cancer frequently develop bone metastases (BM). Zoledronic acid (Zometa®, ZA), routinely used to treat patients with BM, acts on osteoclasts and also has antitumor properties. We aimed to assess the effect of ZA over time in novel bone turnover markers (RANK/receptor activator of nuclear factor-k B ligand (RANK-L)/ Osteoprotegerin (OPG)) and to correlate these with serum N-terminal telopeptide (NTX). The study prospectively evaluated levels of RANK, RANK-L and OPG transcripts by real-time PCR and NTX expression by ELISA in the peripheral blood of 49 consecutive patients with advanced breast, lung or prostate cancer. All patients received the standard ZA schedule and were monitored for 12 months. Median baseline values of RANK, RANK-L and OPG were 78.28 (range 7.34-620.64), 319.06 (21.42-1884.41) and 1.52 (0.10-58.02), respectively. At 12 months, the median RANK-L value had decreased by 22% with respect to the baseline, whereas median OPG levels had increased by about 96%. Consequently, the RANK-L/OPG ratio decreased by 56% from the baseline. Median serum NTX levels decreased over the 12-month period, reaching statistical significance (p < 0.0001). Our results would seem to indicate that ZA modulates RANK, RANK-L and OPG expression, thus decreasing osteoclast activity.
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Affiliation(s)
- Laura Mercatali
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (M.Z.); (W.Z.)
| | - Marianna Ricci
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mail: (E.S.); (P.S.); (F.F.)
| | - Patrizia Serra
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mail: (E.S.); (P.S.); (F.F.)
| | - Francesca Fabbri
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mail: (E.S.); (P.S.); (F.F.)
| | - Rossana Ricci
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (M.Z.); (W.Z.)
| | - Michele Zanoni
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (M.Z.); (W.Z.)
| | - Wainer Zoli
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (M.Z.); (W.Z.)
| | - Roberta Maltoni
- Department of Medical Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mail:
| | - Erica Gunelli
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
| | - Dino Amadori
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), via P. Maroncelli 40, 47014 Meldola (FC), Italy; E-Mails: (L.M.); (M.R.); (R.R.); (C.L.); (E.G.); (D.A.)
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AKTAS BAHRIYE, KASIMIR-BAUER SABINE, LEHMANN NILS, KIMMIG RAINER, TEWES MITRA. Validity of bone marker measurements for monitoring response to bisphosphonate therapy with zoledronic acid in metastatic breast cancer. Oncol Rep 2013; 30:441-7. [DOI: 10.3892/or.2013.2409] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/17/2012] [Indexed: 11/05/2022] Open
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Washam CL, Byrum SD, Leitzel K, Ali SM, Tackett AJ, Gaddy D, Sundermann SE, Lipton A, Suva LJ. Identification of PTHrP(12-48) as a plasma biomarker associated with breast cancer bone metastasis. Cancer Epidemiol Biomarkers Prev 2013; 22:972-83. [PMID: 23462923 DOI: 10.1158/1055-9965.epi-12-1318-t] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Breast cancer bone metastasis is a complication that significantly compromises patient survival due, in part, to the lack of disease-specific biomarkers that allow early and accurate diagnosis. METHODS Using mass spectrometry protein profiling, plasma samples were screened from three independent breast cancer patient cohorts with and without clinical evidence of bone metastasis. RESULTS The results identified 13 biomarkers that classified all 110 patients with a sensitivity of 91% and specificity of 93% [receiver operating characteristics area under the curve (AUC = 1.00)]. The most discriminatory protein was subsequently identified as a unique 12-48aa peptide fragment of parathyroid hormone-related protein (PTHrP). PTHrP(12-48) was significantly increased in plasma of patients with bone metastasis compared with patients without bone metastasis (P < 0.0001). Logistic regression models were used to evaluate the diagnostic potential of PTHrP(12-48) as a single biomarker or in combination with the measurement of the clinical marker N-telopeptide of type I collagen (NTx). The PTHrP(12-48) and NTx logistic regression models were not significantly different and classified the patient groups with high accuracy (AUC = 0.85 and 0.95), respectively. Interestingly, in combination with serum NTx, the plasma concentration of PTHrP(12-48) increased diagnostic specificity and accuracy (AUC = 0.99). CONCLUSIONS These data show that PTHrP(12-48) circulates in plasma of patient with breast cancer and is a novel and predictive biomarker of breast cancer bone metastasis. Importantly, the clinical measurement of PTHrP(12-48) in combination with NTx improves the detection of breast cancer bone metastasis. IMPACT In summary, we present the first validated, plasma biomarker signature for diagnosis of breast cancer bone metastasis that may improve the early diagnosis of high-risk individuals.
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Affiliation(s)
- Charity L Washam
- Department of Orthopaedic Surgery, Center for Orthopaedic Research, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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Vasconcelos ACU, de Azambuja Berti-Couto S, Figueiredo MA, Salum FG, Lopes TG, Cherubini K. Laboratory methods and biomarkers in the evaluation of bisphosphonate effects on body tissues: a literature review. J Oral Pathol Med 2012; 42:577-86. [PMID: 23278676 DOI: 10.1111/jop.12031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2012] [Indexed: 01/06/2023]
Affiliation(s)
- Ana Carolina Uchoa Vasconcelos
- Postgraduate Program; Dental College; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
| | - Soraya de Azambuja Berti-Couto
- Postgraduate Program; Dental College; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
| | - Maria Antonia Figueiredo
- Postgraduate Program; Dental College; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
| | - Fernanda Gonçalves Salum
- Postgraduate Program; Dental College; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
| | - Tiago Giuliani Lopes
- Department of Pathology; School of Medicine; Hospital São Lucas; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
| | - Karen Cherubini
- Postgraduate Program; Dental College; Pontifical Catholic University of Rio Grande do Sul - PUCRS; Porto Alegre RS Brazil
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Lipton A, Cook R, Brown J, Body JJ, Smith M, Coleman R. Skeletal-related events and clinical outcomes in patients with bone metastases and normal levels of osteolysis: exploratory analyses. Clin Oncol (R Coll Radiol) 2012; 25:217-26. [PMID: 23219232 DOI: 10.1016/j.clon.2012.11.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 08/16/2012] [Accepted: 10/02/2012] [Indexed: 11/30/2022]
Abstract
AIMS High levels of bone resorption markers (e.g. N-telopeptide of type I collagen; NTX) have been correlated with increased risks of skeletal-related events and death in patients with bone metastases from solid tumours. However, the disease course has not been well characterised in patients with bone metastases but normal NTX levels. Therefore, the aim of this study was to evaluate the patterns of skeletal morbidity in patients with normal NTX levels. MATERIALS AND METHODS Exploratory analyses were carried out on patients with bone metastases from breast cancer, castration-resistant prostate cancer, non-small cell lung cancer or other solid tumours treated with zoledronic acid (ZOL) in phase III trials. The effects of covariates on the relative risk of death were estimated using the Cox proportional hazard model. The prognostic values of covariates were compared between patients with normal (<64 nmol/mmol creatinine) versus elevated (≥64 nmol/mmol creatinine) NTX levels. RESULTS Among patients with normal baseline NTX (n = 501), less than 10% developed elevated NTX levels before a skeletal-related event or death during ZOL treatment over 12 months. The prognostic factors identified in these analyses were mostly similar across NTX groups. However, some indicators of aggressive disease (e.g. visceral/cerebral metastases from breast cancer) were associated with poor clinical outcomes only in the normal NTX group. CONCLUSIONS Skeletal-related events were generally not preceded or followed by transition to elevated NTX in patients treated with ZOL. Elevated baseline NTX and aggressive extraskeletal disease were independently associated with reduced survival.
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Affiliation(s)
- A Lipton
- Penn State Cancer Center, Milton S. Hershey Medical Center, Pennsylvania State University, Division of Hematology/Oncology, Hershey, PA 17033, USA.
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Effects of sangu decoction on osteoclast activity in a rat model of breast cancer bone metastasis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:381904. [PMID: 23243441 PMCID: PMC3514842 DOI: 10.1155/2012/381904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 09/23/2012] [Accepted: 09/24/2012] [Indexed: 11/18/2022]
Abstract
Bone metastasis (BM) is a major clinical problem for which current treatments lack full efficacy. The Traditional Chinese Medicine (TCM) Sangu Decoction (SGD) has been widely used to treat BM in China. However, no in vivo experiments to date have investigated the effects of TCM on osteoclast activity in BM. In this study, the protective effect and probable mechanism of SGD were evaluated. The model was established using the breast cancer MRMT-1 cells injected into the tibia of rat. SGD was administrated, compared with Zoledronic acid as a positive control. The development of the bone tumor and osteoclast activity was monitored by radiological analysis. TRAP stain was used to identify osteoclasts quantity and activity. TRAP-5b in serum or bone tumor and TRAP mRNA were also quantified. Radiological examination showed that SGD inhibited tumor proliferation and preserved the cortical and trabecular bone structure. In addition, a dramatic reduction of TRAP positive osteoclasts was observed and TRAP-5b levels in serum and bone tumor decreased significantly. It also reduced the mRNA expression of TRAP. The results indicated that SGD exerted potent antiosteoclast property that could be directly related to its TRAP inhibited activity. In addition it prevented bone tumor proliferation in BM model.
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