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