Encounter of cancer cells with bone. Management of bone metastasis arising from prostate cancer

Bone metastases and skeletal complications are major causes of morbidity in prostate cancer patients. Despite an osteoblastic appearance of bone metastases on imaging studies, patients have high osteoclast activity. Current evidence indicates that newer-generation nitrogen-containing bisphosphonates, particularly zoledronic acid, are potent inhibitors of bone resorption via suppression of osteoclast activity. Indeed, zoledronic acid has been reported to significantly decrease the risk of skeletal complications in men with castration-resistant prostate cancer and bone metastases. Additionally, an increased understanding of the pathogenesis of bone metastasis has resulted in the development of several bone-targeted therapies, including a monoclonal antibody targeting the receptor activator of nuclear factor-κB ligand. In this paper, the current state and the future of bone metastases management from prostate cancer are outlined.