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Advantages and Disadvantages of Bone Protective Agents in Metastatic Prostate Cancer: Lessons Learned

机译:骨保护剂在转移性前列腺癌中的优缺点:经验教训

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摘要

Nine out of ten metastatic prostate cancer (PCa) patients will develop osseous metastases. Of these, every second will suffer from skeletal-related events (SRE). SRE are associated with an increased risk for death, which is markedly increased in the presence of pathological fracture. Moreover, health insurance costs nearly double in the presence of SRE. Zoledronic acid and denosumab are both approved drugs for the prevention or delay of SRE in castration-resistant prostate cancer (CRPC) patients with osseous metastases. However, long-term treatment with one of these two drugs is associated with the development of medication-related osteonecrosis of the jaw (MRONJ). Routine inspections of the oral cavity before and during treatment are mandatory in these patients. Regarding imaging techniques, bone scintigraphy seems to be a promising tool to detect early stage MRONJ. Zoledronic acid does not reduce the incidence of SRE in hormone-sensitive PCa. First data shows 3-monthly application of zoledronic acid to be equi-effective to monthly application.
机译:十分之九的转移性前列腺癌(PCa)患者中会发生骨转移。其中,每秒将遭受骨骼相关事件(SRE)。 SRE与死亡风险增加相关,在存在病理性骨折的情况下,死亡风险显着增加。此外,在SRE的情况下,健康保险的费用几乎翻了一番。唑来膦酸和地诺单抗都是批准用于预防或延迟具有骨转移的去势抵抗性前列腺癌(CRPC)患者中SRE的药物。但是,使用这两种药物中的一种进行长期治疗与药物相关的颌骨坏死(MRONJ)的发展有关。这些患者必须在治疗前和治疗过程中对口腔进行常规检查。关于成像技术,骨闪烁扫描似乎是检测早期MRONJ的有前途的工具。唑来膦酸不会降低激素敏感型PCa中SRE的发生率。第一项数据显示唑来膦酸的3个月一次施用与每月一次施用等效。

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