Recently, a plethora of life-prolonging cytotoxic, next-generation hormonal, immunotherapeutical as well as radionuclide therapies has emerged as a standard care for metastasized castration-resistant prostate cancer. Being strikingly effective in cancer control, these novel therapies might in fact exert a beneficial impact on skeletal events. Therefore, combining anticancer drugs with osteoprotective agents might lead to additional clinical advantage but must be weighed against simultaneously exposing patients to serious toxicities. In addition, further survival prolongation by changing treatment paradigm in both metastasized hormone-sensitive and nonmetastatic castration-resistant disease might potentially increase the risk for bone density reduction complications due to a growing efficacy of androgen ablation leading to prolonged exposure. To address both possible indications of combined treatment and to draw practical conclusions, we performed a comprehensive review of the currently available evidence.
Urologic oncology. 2018 Sep 26 [Epub ahead of print]
Igor Tsaur, Isabel Heidegger, Alexander Kretschmer, Hendrik Borgmann, Cristian Mirvald, Giorgio Gandaglia, Alberto Briganti, Roderick van den Bergh, Derya Tilki, Piet Ost, Guillaume Ploussard, Cristian Surcel, EAU-YAU Prostate Cancer Working Party
Department of Urology and Pediatric Urology, Mainz University Medicine, Mainz, Germany. Electronic address: ., Department of Urology, Medical University Innsbruck, Innsbruck, Austria., Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany., Department of Urology and Pediatric Urology, Mainz University Medicine, Mainz, Germany., Department of Urology, Fundeni Clinical Institute, University of Medicine and Pharmacy, Carol Davila Bucharest, Bucharest, Romania., Department of Urology, Urological Research Institute, Vita-Salute University and San Raffaele Hospital, Milan, Italy., Department of Urology, Antonius Hospital, Utrecht, The Netherlands., Department of Urology, Martini Klinik, Hamburg, Germany., Department of radiation oncology and experimental cancer research, Ghent University Hospital, Ghent, Belgium., Department of Urology, Saint Jean Languedoc Hospital, Toulouse, France and Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France.