Assessing Combination of Osteoprotective Agents and Anticancer Drugs in Prostate Cancer
Posted: Monday, December 3, 2018
According to a review article published in Urologic Oncology, combining osteoprotective agents with anticancer drugs in patients with prostate cancer does not seem to increase toxicity and may lead to additional clinical advantage. Igor Tsaur, MD, of Mainz University Medicine in Germany, and colleagues evaluated existing research to determine the effects of this concomitant treatment in both patients with metastatic castration-resistant cancer and patients with metastatic hormone-sensitive cancer.
“In these patients, changes in bone metabolism can imply a significant impact on all-cause morbidity as well as cancer-related outcomes,” noted the researchers. “This is of utmost clinical importance since bone metastases are by far the most frequent metastatic sites in prostate cancer patients.”
In reviewing the available research, the authors found the most evidence that supported combining osteoprotective agents with docetaxel for patients with prostate cancer. This concomitant treatment was found to be as safe as docetaxel monotherapy, with the additional benefit of prevention of skeletal complications for patients with metastatic castration-resistant disease as well as cost-effectiveness, although the authors noted that the effect of this treatment on survival outcomes is unknown. A combination treatment of osteoprotective agents plus radium-223 was found to be similarly well tolerated and effective in preventing skeletal complications in this patient population.
Conversely, patients with metastatic hormone-sensitive prostate cancer infrequently experience skeletal-related events due to the effectiveness of disease control monotherapy. The researchers did find that patients with metastatic hormone-sensitive prostate cancer may benefit from the combination of osteoprotective agents and anticancer drugs, such as docetaxel, in preventing both bone loss and osteoporotic fracture.