Therapeutic Approaches to Metastatic Bone Cancer II: Targeted and Non-targeted Systemic Agents

Abstract

Skeletal metastases occur most commonly in the advanced stages of prostate, breast, and lung cancer, but also can occur in thyroid cancer and renal cell carcinoma (RCC) [22]. The skeleton is the third most common organ affected by metastases from these solid tumors [17]. In general, bone metastases disrupt normal bone remodeling to cause either osteolytic or osteoblastic bone lesions. Metastatic breast cancer and renal cell cancer are often associated with osteolytic bone lesions. Prostate cancer is associated primarily with osteoblastic lesions [8]. Bone metastases cause significant morbidity, including pain, hypercalcemia, pathologic fractures, and spinal cord or nerve root compression. Bone metastases can occasionally lead to life-threatening complications, and most commonly do so for patients with bone metastases from breast and lung cancer [17].