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Current status and future directions in the treatment of bone metastases from breast cancer

机译：来自乳腺癌骨转移的现状和未来方向

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Abstract The clinical treatment of bone metastasis from breast cancer is currently based on the systemic administration of antiresorptive agents, radiopharmaceuticals, and/or local treatments such as radiation therapy, radiofrequency ablation and surgery. However, these therapeutic options are merely palliative and do not show to have a significant positive impact on patients’ survival. In addition, the systemic administration of antiresorptive drugs and/or antitumour agents and/or radiopharmaceuticals may negatively affect normal bone metabolism with detrimental consequences for cancer patients. Hence, the need to identify alternative therapeutic strategies that, based on the hallmarks of bone metastasis, can effectively thwart tumour cell growth while, at the same time, overcoming antitumour drug‐induced bone loss and preserving bone health. To this aim, current studies are directed toward the development of new molecules with low toxicity and/or novel drug delivery systems, which may efficiently hinder the growth of metastatic cells, while other studies are focussed on the design of new clinical treatments that, by acting on early stages of breast cancer, may prevent the?homing and the subsequent growth of cancer?cells in ? the ? bone. These treatments might also target occult micro‐metastases before their development into clinically evident bone lesions, ultimately hindering bone relapse and disease progression. However, this therapeutic approach implies the identification of early stage breast cancer patients being at high risk of developing bone metastases. The discovery of novel specific biomarkers as predictor of metastatic bone disease may help clinicians in selecting these patients.
机译：摘要目前基于乳腺癌骨转移的临床治疗目前基于对抗化剂，放射性药物和/或局部治疗，如放射治疗，射频消融和手术等局部治疗。然而，这些治疗选择仅仅是姑息性的，并没有表现出对患者的生存产生显着的积极影响。此外，抗血管药物和/或抗溶解剂和/或放射性药物的全身施用可能对癌症患者的不利后果产生负面影响正常骨代谢。因此，需要识别基于骨转移的标志的替代治疗策略，可以有效地挫败肿瘤细胞生长，同时克服抗真菌药物诱导的骨质损失和保持骨骼健康。为此目的，目前的研究旨在开发具有低毒性和/或新药递送系统的新分子，这可能有效地阻碍转移细胞的生长，而其他研究则重点是新的临床治疗的设计，通过在乳腺癌的早期阶段作用，可能会阻止？归巢和随后的癌症生长？细胞？这 ？骨。这些治疗还可在其开发前靶向神经转移术，并最终妨碍骨复发和疾病进展。然而，这种治疗方法意味着早期乳腺癌患者处于高风险骨转移的鉴定。将新的特异性生物标志物的发现作为转移性骨病的预测因子可能有助于临床医生选择这些患者。

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