Bone-Targeted Therapies in Men Being Treated for Prostate Cancer: Review Reveals Paucity of Evidence — Physician’s First Watch

Medical News |
August 8, 2017

Bone-Targeted Therapies in Men Being Treated for Prostate Cancer: Review Reveals Paucity of Evidence

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Bisphosphonates improve bone mineral density (BMD) in men with prostate cancer receiving androgen deprivation therapy, but there's no evidence of a fracture-prevention benefit, finds a systematic review in the Annals of Internal Medicine.

Researchers examined data from two reviews and 27 randomized controlled trials of bone-targeted therapies in men with nonmetastatic prostate cancer who were beginning or continuing androgen deprivation therapy. Among the findings:

  • Bisphosphonates, compared with no bisphosphonates, significantly increased BMD at the lumbar spine, femoral neck, and total spine at 12 months. No trials were powered to detect a decrease in fractures.

  • Denosumab, compared with placebo, significantly reduced radiographic vertebral fractures at 12, 24, and 36 months, but the findings were limited to one high-quality trial. (Denosumab is a monoclonal antibody that inhibits RANKL, a protein necessary for osteoclast formation and function.)

  • Exercise showed no benefit over usual care in improving BMD in three trials.

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