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Urologic Oncology pp 1–16Cite as

Bone Target Therapy in Urologic Malignancies

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Abstract

Almost 90% of patients with advanced prostate cancer and only 30% of patients with urothelial and renal cell carcinoma develop bone metastases. Patients with bone metastases have a high risk of skeletal-related events such as fractures and spinal cord compression. These events have a significant impact on quality of life as well as tumor progression. Both bisphosphonates and the RANKL-targeting antibody denosumab have shown to have a significant positive impact on skeletal-related events. Whereas for metastatic castration-resistant prostate cancer, phase III randomized trials have confirmed positive effects of denosumab and zoledronic acid on bone-related morbidity, only little evidence is present for application of these agents in bladder or renal cell carcinoma. Whereas denosumab has proven to delay onset of bone metastases in CRPC patients without bone metastases, zoledronic acid failed to prove a bone metastasis-preventing effect. The application of this agent in castration-sensitive PC is discussed controversially after a clinical trial has shown no benefit of zoledronic acid in this setting.

In patients with advanced prostate cancer and multiple bone metastases, therapy with radiopharmaceuticals is of utmost importance. Especially treatment with the alpha-emitter radium-223 chloride causes a significant delay of symptomatic skeletal-related events as well as a significant improved overall survival both in the initial phase III trial and the data of the early access program. Data on the use of radium-223 in other urologic malignancies is limited.

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  1. Departement of Urology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany

    Simone Bier, Tilman Todenhöfer & Arnulf Stenzl

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  1. Simone Bier
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  2. Tilman Todenhöfer
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  1. Dept. of Urology & Urologic Oncology, Hannover Medical School, Hannover, Germany

    Axel S. Merseburger

  2. Dept. of Urology, University of Regensburg St. Josef Medical Centre, Regensburg, Germany

    Maximilian Burger

Section Editor information

  1. Klinik und Poliklinik für Urologie, Universität Regensburg/Caritas-Krankenhaus St. Josef, Landshuter Str. 65, 93053, Regensburg, Germany

    Maximilian Burger

  2. Department of Urology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Axel S. Merseburger

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© 2017 Springer International Publishing AG

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Bier, S., Todenhöfer, T., Stenzl, A. (2017). Bone Target Therapy in Urologic Malignancies. In: Merseburger, A., Burger, M. (eds) Urologic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42603-7_51-1

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  • DOI: https://doi.org/10.1007/978-3-319-42603-7_51-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42603-7

  • Online ISBN: 978-3-319-42603-7

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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