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The prevention of fragility fractures in patients with non-metastatic prostate cancer: A position statement by the international osteoporosis foundation
Cianferotti, Luisella Bertoldo, Francesco Carini, Marco Kanis, John A. Lapini, Alberto Longo, Nicola Martorana, Giuseppe Mirone, Vincenzo Reginster, Jean-Yves Rizzoli, Rene
Cianferotti, Luisella
Bertoldo, Francesco
Carini, Marco
Kanis, John A.
Lapini, Alberto
Longo, Nicola
Martorana, Giuseppe
Mirone, Vincenzo
Reginster, Jean-Yves
Rizzoli, Rene
Abstract
Androgen deprivation therapy is commonly employed for the treatment of non-metastatic prostate cancer as primary or adjuvant treatment. The skeleton is greatly compromised in men with prostate cancer during androgen deprivation therapy because of the lack of androgens and estrogens, which are trophic factors for bone. Men receiving androgen deprivation therapy sustain variable degrees of bone loss with an increased risk of fragility fractures. Several bone antiresorptive agents have been tested in randomized controlled trials in these patients. Oral bisphosphonates, such as alendronate and risedronate, and intravenous bisphosphonates, such as pamidronate and zoledronic acid, have been shown to increase bone density and decrease the risk of fractures in men receiving androgen deprivation therapy. Denosumab, a fully monoclonal antibody that inhibits osteoclastic-mediated bone resorption, is also effective in increasing bone mineral density and reducing fracture rates in these patients. The assessment of fracture risk, T-score and/or the evaluation of prevalent fragility fractures are mandatory for the selection of patients who will benefit from antiresorptive therapy. In the future, new agents modulating bone turnover and skeletal muscle metabolism will be available for testing in these subjects.
Keywords
Date
2017
Type
Journal article
Journal
Oncotarget
Book
Volume
8
Issue
43
Page Range
75646-75663
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
CC BY 3.0
File Access
Open