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Supportive Care in Cancer
Published in: Supportive Care in Cancer 6/2013

01-06-2013 | Review Article

Reducing the burden of bone metastases

Current concepts and treatment options

Authors: Roger von Moos, Cora Sternberg, Jean-Jacques Body, Carsten Bokemeyer

Published in: Supportive Care in Cancer | Issue 6/2013

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Abstract

Background

Bone metastases occur frequently in patients with solid tumours such as those of the prostate, breast and lung, and are associated with an increased risk of skeletal-related events (SREs). This article reviews the personal, social and economic burdens of bone metastases and SREs, and approaches to treatment.

Methods

PubMed searches were conducted using a broad range of search terms. Articles identified were refined by author review of abstracts. Additional material was identified by searching recent relevant congress abstracts.

Results

Bone metastases often decrease quality of life, but quantitative data on the extent of this effect are limited. Data from the USA demonstrate a significant financial burden associated with bone metastases; similar trends are now being uncovered in Europe as the number of assessments of health economics and healthcare resource utilisation in the region increases. The bisphosphonate zoledronic acid reduces the incidence of SREs compared with placebo. Recent phase 3 studies have shown that therapy with the RANK ligand inhibitor denosumab is superior to zoledronic acid for preventing or delaying SREs in patients with bone metastases from solid tumours. Denosumab also has a comparable safety profile to bisphosphonates, with reduced risk of renal toxicity and acute phase reactions. Data from Europe suggest that denosumab is cost-effective for the prevention of SREs compared with zoledronic acid. Additionally, several new experimental bone-targeted agents show promise.

Conclusion

Recent progress may help to reshape evidence-based guidelines to improve patient care and reduce the economic burden of bone metastases.
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Metadata
Title
Reducing the burden of bone metastases
Current concepts and treatment options
Authors
Roger von Moos
Cora Sternberg
Jean-Jacques Body
Carsten Bokemeyer
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 6/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1755-1

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