Osteolytic metastasis in breast cancer: effective prevention strategies

Expert Rev Anticancer Ther. 2020 Sep;20(9):797-811. doi: 10.1080/14737140.2020.1807950. Epub 2020 Aug 31.

Abstract

Introduction: Breast cancer is the most common cancer in women throughout the world. Patients who are diagnosed early generally have better prognosis and survivability. Indeed, advanced stage breast cancer often develops osteolytic metastases, leading to bone destruction. Although there are select drugs available to treat bone metastatic disease, these drugs have shown limited success.

Area covered: This paper emphasizes updated mechanisms of bone remodeling and osteolytic bone metastases of breast cancer. This article also aims to explore the potential of novel natural and synthetic therapeutics in the effective prevention of breast cancer-induced osteolysis and osteolytic metastases of breast cancer.

Expert opinion: Targeting TGFβ and BMP signaling pathways, along with osteoclast activity, appears to be a promising therapeutic strategy in the prevention of breast cancer-induced osteolytic bone destruction and metastatic growth at bone metastatic niches. Pilot studies in animal models suggest various natural and synthetic compounds and monoclonal antibodies as putative therapeutics in the prevention of breast cancer stimulated osteolytic activity. However, comprehensive pre-clinical studies demonstrating the PK/PD and in-depth understanding of molecular mechanism(s) by which these potential molecules exhibit anti-tumor growth and anti-osteolytic activity are still required to develop effective therapies against breast cancer-induced osteolytic bone disease.

Keywords: Breast cancer; bone metastasis; bone remodeling; osteoclast activity; osteolysis; potential molecules; prevention strategy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacology
  • Bone Neoplasms / prevention & control*
  • Bone Neoplasms / secondary
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Female
  • Humans
  • Molecular Targeted Therapy
  • Neoplasm Staging
  • Osteoclasts / metabolism
  • Osteolysis / etiology
  • Osteolysis / prevention & control*
  • Prognosis
  • Signal Transduction

Substances

  • Antineoplastic Agents