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SEOM guidelines for the treatment of bone metastases from solid tumours

  • Clincal Guides in Oncology
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Abstract

Bone metastases are a common and distressing effect of cancer, being a major cause of morbidity in many patients with advanced stage cancer, in particular in breast and prostate cancer. Patients with bone metastases can experience complications known as skeletal-related events (SREs) which may cause significant debilitation and have a negative impact on quality of life and functional independence. The current recommended systemic treatment for the prevention of SREs is based on the use of bisphosphonates: ibandronate, pamidronate and zoledronic acid-the most potent one-are approved in advanced breast cancer with bone metastases, whereas only zoledronic acid is indicated in advanced prostate cancer with bone metastases. The 2011 ASCO guidelines on breast cancer, recommend initiating bisphosphonate treatment only for patients with evidence of bone destruction due to bone metastases. Denosumab, a fully human antibody that specifically targets the RANK-L, has been demonstrated in two phase III studies to be superior to zoledronic acid in preventing or delaying SREs in breast and prostate cancer and non-inferior in other solid tumours and mieloma; it's convenient subcutaneous administration and the fact that does not require dose adjustment in cases of renal impairment, make this agent an attractive new therapeutic option in patients with bone metastases. Finally, in a phase III study against placebo, denosumab significantly increased the median metastasisfree survival in high risk non-metastatic prostate cancer, arising the potential role of these bone-modifying agents in preventing or delaying the development of bone metastases.

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Authors and Affiliations

  1. Medical Oncology Department, Hospital Universitario de Guadalajara, C/ del Donante de Sangre, s/n, ES-19002, Guadalajara, Spain

    Javier Cassinello Espinosa & Esther Holgado Martín

  2. Medical Oncology Department, Hospital Universitario Son Espases Palma de Mallorca, Baleares, Spain

    Aránzazu González del Alba Baamonde

  3. Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain

    Fernando Rivera Herrero

Authors
  1. Javier Cassinello Espinosa
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  2. Aránzazu González del Alba Baamonde
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  3. Fernando Rivera Herrero
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  4. Esther Holgado Martín
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Correspondence to Javier Cassinello Espinosa.

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Cassinello Espinosa, J., González del Alba Baamonde, A., Rivera Herrero, F. et al. SEOM guidelines for the treatment of bone metastases from solid tumours. Clin Transl Oncol 14, 505–511 (2012). https://doi.org/10.1007/s12094-012-0832-0

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  • DOI: https://doi.org/10.1007/s12094-012-0832-0

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