This Article Full Text Full Text (PDF) CME: Take the course for this article: Cancer Treatment-Induced Bone Loss: Pathophysiology and Clinical Perspectives eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Google Scholar Articles by Brufsky, A. M. PubMed PubMed Citation Articles by Brufsky, A. M.

Symptom Management and Supportive Care

Cancer Treatment-Induced Bone Loss: Pathophysiology and Clinical Perspectives

University of Pittsburgh School of Medicine, Magee-Women's Hospital, Pittsburgh, Pennsylvania, USA

Key Words. Androgen deprivation therapy • Aromatase inhibitor • Bisphosphonate • Bone loss • Osteoporosis Zoledronic acid

Correspondence: Adam M. Brufsky, M.D., Ph.D., University of Pittsburgh School of Medicine, Magee-Women's Hospital, Suite 4628, Pittsburgh, Pennsylvania 15213, USA. Telephone: 412-641-6500; Fax: 412-641-2296; e-mail: brufskyam{at}upmc.edu

Disclosure: A.M.B. has participated in the speakers bureau for Novartis Pharmaceuticals. Funding for medical editorial assistance was provided by Novartis Pharmaceuticals Corporation. No other potential conflicts of interest were reported by the author, planners, reviewers, or staff managers of this article.

Hormone-ablative therapies for breast or prostate cancer can cause marked and rapid reductions in circulating estrogen or testosterone levels, resulting in significant effects on bone metabolism and cancer treatment–induced bone loss (CTIBL). Most patients with cancer are over the age of 65 and are already at risk for osteoporosis. Thus, accelerated bone loss from CTIBL is especially concerning in this population. Although there are currently no approved therapies for the treatment or prevention of CTIBL, oral bisphosphonates have been used in settings other than oncology to treat bone loss. New-generation i.v. bisphosphonates have demonstrated promising activity in preventing CTIBL in patients receiving hormonal therapy for breast or prostate cancer. In particular, zoledronic acid not only prevents CTIBL in both breast and prostate cancer patients but also increases bone mineral density above baseline. Such agents have the potential to delay or prevent CTIBL in patients receiving hormonal therapies.