Abstract
Bone cancer is a demanding challenge for contemporary medicine due to its high frequency of presentation and significant heterogeneity of malignant lesions developing within the bone. To date, available treatments are rarely curative and are primarily aimed at prolonging patients’ survival and ameliorating their quality of life. Furthermore, both pharmacological and surgical therapies are aggravated by a consistent burden of adverse events and subsequent disability due to the loss of healthy bone structural and functional properties. Therefore, great research efforts are being made to develop innovative biomaterials able to selectively inhibit bone cancer progression while reducing the loss of bone structural properties secondary to local tissue invasion. In this review, we describe the state of the art of innovative biomaterials for the treatment of bone cancer. Along with physiological bone remodeling, the development of bone metastasis and osteosarcoma will be depicted. Subsequently, recent advances on nanocarrier-based drug delivery systems, as well as the application of novel, multifunctional biomaterials for the treatment of bone cancer will be discussed. Eventually, actual limitations and promising future perspectives regarding the employment of such approaches in the clinical scenario will be debated.
Highlights
It has been estimated that up to 75% of patients affected by stage IV breast cancer will develop a bone metastasis [6], while approximately 20% of patients with early-stage breast cancer will present bone metastatic lesions after a mean follow-up of 8.4 years, according to a large cohort study [7]
The purpose of this review is to describe the current state of the art on the development of innovative biomaterials to treat metastases and primary cancers of the bone
Sci. 2021, 22, 8214 secreted matrix, osteoblasts become entrapped in lacunae, eventually transitioning to osteocytes, stellate-shaped cells communicating via cytoplasmic processes extending within bone canaliculi [18]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Treatment of SREs is multimodal and frequently involves the administration of drugs (i.e., analgesics, bisphosphonates, RANKL inhibitors, radiopharmaceuticals) as well as locoregional (i.e., radiotherapy, vertebroplasty, kyphoplasty) and surgical approaches (i.e., nerve decompression and/or fracture fixation surgeries) These treatments mainly aim at decreasing the rate of SREs and only a small fraction of them can transiently reduce metastatic cell turnover and proliferation, achieving local tumor control [10]. They are often aggravated by serious side effects (e.g., hypocalcemia, kidney failure, osteonecrosis of the jaw for most anti-resorptive drugs [10], myelotoxicity and a higher risk of fracture following radiation therapy [11]) that may further increase the disease burden in treated patients. Future perspectives and actual limitations of biomaterials in current use will be discussed
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