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Cancers
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Bone Health Management in the Continuum of Prostate Cancer Disease
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Bone Health Management in the Continuum of Prostate Cancer Disease

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 16310

Special Issue Editor

Prof. Dr. Santini Daniele

E-Mail Website
Guest Editor
Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
Interests: Hepatocellular carcinoma; Bone metastasis; Colorectal tumors; Kidney tumors; Gastric cancers

Special Issue Information

Dear Colleagues,

Bone health impairment is a frequent detrimental consequence of the high bone tropism of prostate cancer (PCa) cells. It is further worsened by the administration of androgen-deprivation therapy (ADT, the current standard of care in the management of advanced PCa), through a rapid and dramatic increase in bone turnover and body mass changes. As a result, patients experience substantial pain and poor quality of life (QoL) and have an increased risk of death. Notwithstanding the importance of this issue, however, bone health preservation is not yet a widespread clinical goal in daily practice. To address this urgent unmet need, following a thorough discussion of available data and sharing of their clinical practice experience, a panel of international experts in the field of bone health and metabolism will formulate a collection of advice for optimizing the monitoring and treatment of bone health in men undergoing ADT during all phases of the disease. The rationale behind the venture is to raise awareness on the importance of bone preservation in this complex setting while providing an instrument to support physicians and facilitate the management of bone health.

This Special Issue will review current evidence regarding the effects of ADT on bone health, of novel hormone therapies (which improve progression delay, pain control, and QoL while consistently carrying the risk of non-pathological fractures in both non-metastatic and metastatic PCa), and of bone turnover inhibitors (BTTs, whose use is frequently suboptimal). Finally, expert opinion on optimizing bone health preservation will be given.

Prof. Santini Daniele
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone health
  • prostate cancer
  • ADT
  • last-generation hormonotherapy
  • bone microenvironment

Published Papers (4 papers)

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Research

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13 pages, 1755 KiB  
Article
Assessing Therapeutic Response to Radium-223 with an Automated Bone Scan Index among Metastatic Castration-Resistant Prostate Cancer Patients: Data from Patients in the J-RAP-BSI Trial
by Kazuhiro Kitajima, Junpei Kuyama, Takashi Kawahara, Tsuyoshi Suga, Tomoaki Otani, Shigeyasu Sugawara, Yumiko Kono, Yukihisa Tamaki, Ayumi Seko-Nitta, Yoshinobu Ishiwata, Kimiteru Ito, Akira Toriihara, Shiro Watanabe, Makoto Hosono, Hideaki Miyake, Shingo Yamamoto, Ryohei Sasaki, Mitsuhiro Narita and Koichiro Yamakado
Cancers 2023, 15(10), 2784; https://doi.org/10.3390/cancers15102784 - 16 May 2023
Cited by 3 | Viewed by 1894
Abstract
To evaluate the usefulness of change in the automated bone scan index (aBSI) value derived from bone scintigraphy findings as an imaging biomarker for the assessment of treatment response and survival prediction in metastatic castration-resistant prostate cancer (mCRPC) patients treated with Ra-223. This [...] Read more.
To evaluate the usefulness of change in the automated bone scan index (aBSI) value derived from bone scintigraphy findings as an imaging biomarker for the assessment of treatment response and survival prediction in metastatic castration-resistant prostate cancer (mCRPC) patients treated with Ra-223. This study was a retrospective investigation of a Japanese cohort of 205 mCRPC patients who received Ra-223 in 14 hospitals between July 2016 and August 2020 and for whom bone scintigraphy before and after radium-223 treatment was available. Correlations of aBSI change, with changes in the serum markers alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were evaluated. Additionally, the association of those changes with overall survival (OS) was assessed using the Cox proportional-hazards model and Kaplan–Meier curve results. Of the 205 patients enrolled, 165 (80.5%) completed six cycles of Ra-223. Following treatment, ALP decline (%ALP < 0%) was noted in 72.2% (148/205), aBSI decline (%aBSI < 0%) in 52.7% (108/205), and PSA decline (%PSA < 0%) in 27.8% (57/205). Furthermore, a reduction in both aBSI and ALP was seen in 87 (42.4%), a reduction in only ALP was seen in 61 (29.8%), a reduction in only aBSI was seen in 21 (10.2%), and in both aBSI and ALP increasing/stable (≥0%) was seen in 36 (17.6%) patients. Multiparametric analysis showed changes in PSA [hazard ratio (HR) 4.30, 95% confidence interval (CI) 2.32–8.77, p < 0.0001], aBSI (HR 2.22, 95%CI 1.43–3.59, p = 0.0003), and ALP (HR 2.06, 95%CI 1.35–3.14, p = 0.0008) as significant prognostic factors for OS. For mCRPC patients treated with Ra-223, aBSI change is useful as an imaging biomarker for treatment response assessment and survival prediction. Full article
(This article belongs to the Special Issue Bone Health Management in the Continuum of Prostate Cancer Disease)
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Review

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23 pages, 3866 KiB  
Review
Bone Health Management in the Continuum of Prostate Cancer Disease
by Ettickan Boopathi, Ruth Birbe, Sunday A. Shoyele, Robert B. Den and Chellappagounder Thangavel
Cancers 2022, 14(17), 4305; https://doi.org/10.3390/cancers14174305 - 2 Sep 2022
Cited by 9 | Viewed by 4172
Abstract
Prostate cancer (PCa) is the second-leading cause of cancer-related deaths in men. PCa cells require androgen receptor (AR) signaling for their growth and survival. Androgen deprivation therapy (ADT) is the preferred treatment for patients with locally advanced and metastatic PCa disease. Despite their [...] Read more.
Prostate cancer (PCa) is the second-leading cause of cancer-related deaths in men. PCa cells require androgen receptor (AR) signaling for their growth and survival. Androgen deprivation therapy (ADT) is the preferred treatment for patients with locally advanced and metastatic PCa disease. Despite their initial response to androgen blockade, most patients eventually will develop metastatic castration-resistant prostate cancer (mCRPC). Bone metastases are common in men with mCRPC, occurring in 30% of patients within 2 years of castration resistance and in >90% of patients over the course of the disease. Patients with mCRPC-induced bone metastasis develop lesions throughout their skeleton; the 5-year survival rate for these patients is 47%. Bone-metastasis-induced early changes in the bone that proceed the osteoblastic response in the bone matrix are monitored and detected via modern magnetic resonance and PET/CT imaging technologies. Various treatment options, such as targeting osteolytic metastasis with bisphosphonates, prednisone, dexamethasone, denosumab, immunotherapy, external beam radiation therapy, radiopharmaceuticals, surgery, and pain medications are employed to treat prostate-cancer-induced bone metastasis and manage bone health. However, these diagnostics and treatment options are not very accurate nor efficient enough to treat bone metastases and manage bone health. In this review, we present the pathogenesis of PCa-induced bone metastasis, its deleterious impacts on vital organs, the impact of metastatic PCa on bone health, treatment interventions for bone metastasis and management of bone- and skeletal-related events, and possible current and future therapeutic options for bone management in the continuum of prostate cancer disease. Full article
(This article belongs to the Special Issue Bone Health Management in the Continuum of Prostate Cancer Disease)
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13 pages, 534 KiB  
Review
Bone Targeting Agents in Patients with Metastatic Prostate Cancer: State of the Art
by Veronica Mollica, Alessandro Rizzo, Matteo Rosellini, Andrea Marchetti, Angela Dalia Ricci, Alessia Cimadamore, Marina Scarpelli, Chiara Bonucci, Elisa Andrini, Costantino Errani, Matteo Santoni, Rodolfo Montironi and Francesco Massari
Cancers 2021, 13(3), 546; https://doi.org/10.3390/cancers13030546 - 1 Feb 2021
Cited by 30 | Viewed by 4349
Abstract
Bone health represents a major issue in castration-resistant prostate cancer (CRPC) patients with bone metastases; in fact, the frequently prolonged use of hormonal agents causes important modifications in physiological bone turnover and most of these men will develop skeletal-related events (SREs), including spinal [...] Read more.
Bone health represents a major issue in castration-resistant prostate cancer (CRPC) patients with bone metastases; in fact, the frequently prolonged use of hormonal agents causes important modifications in physiological bone turnover and most of these men will develop skeletal-related events (SREs), including spinal cord compression, pathologic fractures and need for surgery or radiation to bone, which are estimated to occur in almost half of this patient population. In the last decade, several novel therapeutic options have entered into clinical practice of bone metastatic CRPC, with recent approval of enzalutamide and abiraterone acetate, cabazitaxel chemotherapy and radium-223, on the basis of survival benefit suggested by landmark Phase III trials assessing these agents in this setting. Conversely, although bone-targeted agents (BTAs)—such as the bisphosphonate zoledronic acid and the receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor denosumab—are approved for the prevention of SREs, these compounds have not shown benefit in terms of overall survival. However, emerging evidence has suggested that the combination of BTAs and abiraterone acetate, enzalutamide and the radiopharmaceutical radium-223 could result in improved clinical outcomes and prolonged survival in bone metastatic CRPC. In this review, we will provide an overview on bone tropism of prostate cancer and on the role of BTAs in metastatic hormone-sensitive and castration-resistant prostate cancer. Full article
(This article belongs to the Special Issue Bone Health Management in the Continuum of Prostate Cancer Disease)
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16 pages, 539 KiB  
Review
Pathophysiology of Bone Loss in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy and Lifestyle Modifications for the Management of Bone Health: A Comprehensive Review
by Tae Jin Kim and Kyo Chul Koo
Cancers 2020, 12(6), 1529; https://doi.org/10.3390/cancers12061529 - 10 Jun 2020
Cited by 6 | Viewed by 5189
Abstract
Androgen-deprivation therapy (ADT) is a systemic therapy administered for the management of advanced prostate cancer (PCa). Although ADT may improve survival, long-term use reduces bone mass density (BMD), posing an increased risk of fracture. Considering the long natural history of PCa, it is [...] Read more.
Androgen-deprivation therapy (ADT) is a systemic therapy administered for the management of advanced prostate cancer (PCa). Although ADT may improve survival, long-term use reduces bone mass density (BMD), posing an increased risk of fracture. Considering the long natural history of PCa, it is essential to preserve bone health and quality-of-life in patients on long-term ADT. As an alternative to pharmacological interventions targeted at preserving BMD, current evidence recommends lifestyle modifications, including individualized exercise and nutritional interventions. Exercise interventions include resistance training, aerobic exercise, and weight-bearing impact exercise, and have shown efficacy in preserving BMD. At the same time, it is important to take into account that PCa is a progressive and debilitating disease in which a substantial proportion of patients on long-term ADT are older individuals who harbor axial bone metastases. Smoking cessation and limited alcohol consumption are commonly recommended lifestyle measures in patients receiving ADT. Contemporary guidelines regarding lifestyle modifications vary by country, organization, and expert opinion. This comprehensive review will provide an evidence-based, updated summary of lifestyle interventions that could be implemented to preserve bone health and maintain quality-of-life throughout the disease course of PCa. Full article
(This article belongs to the Special Issue Bone Health Management in the Continuum of Prostate Cancer Disease)
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