Therapies for Bone Metastasis in Prostate Cancer: Comparison
Please note this is a comparison between Version 1 by Tie Zhou and Version 2 by Sirius Huang.

In the absence of early detection and initial treatment, prostate cancer often progresses to an advanced stage, frequently spreading to the bones and significantly impacting patients’ well-being and healthcare resources. Therefore, managing patients with prostate cancer that has spread to the bones often involves using bone-targeted medications like bisphosphonates and denosumab to enhance bone structure and minimize skeletal complications. Additionally, researchers are studying the tumor microenvironment and biomarkers to understand the mechanisms and potential treatment targets for bone metastases in prostate cancer. 

  • prostate cancer
  • bone metastasis
  • bone-targeted therapies
  • skeletal-related event

1. Introduction

Prostate cancer (PCa) is a prevalent malignant tumor in the United States, ranking second in terms of mortality rate after lung cancer [1]. There exists a significant disparity in the occurrence rate of prostate cancer between China (10.2/100,000) and North America (73.0/100,000), with both the incidence and mortality rates showing a consistent upward trend in recent years [2][3][2,3]. The 2014 China Multicenter Report revealed that a significant proportion of Chinese patients (approximately 30.5%) diagnosed with prostate cancer had already developed distant metastases at the time of initial diagnosis, which is considerably higher compared to the rates observed in North America [4]. Nowadays, the treatment options for patients diagnosed with metastatic prostate cancer (mPCa) have shown significant advancements in recent years. Androgen deprivation therapy (ADT) serves as the primary treatment for this condition. Additional treatment options encompass chemotherapy, new generation hormone therapy, radium-223, and, more recently, radioligand therapy. Special considerations should be directed toward the management of bone health and the prevention of treatment-induced bone loss in these patients [5]. Among individuals diagnosed with castration-resistant prostate cancer (CRPC), bone metastasis is commonly detected in 70% to 90% of patients through imaging examinations [6]. Bone metastases give rise to the occurrence of skeletal-related events (SREs), which encompass severe pain, pathological fracture, spinal cord/intervertebral nerve compression, and hypercalcemia [5]. Preventing and reducing the occurrence of SREs, relieving pain caused by bone metastases, and improving patients’ quality of life are the goals of treatment. The management of bone metastases in prostate cancer has undergone significant advancements due to the enhanced comprehension of the disease’s progression, signaling pathways, mutational characteristics, and mechanisms of drug resistance. Table 1 and Figure 1 summarize the main pathways and mechanisms of action of the principal PC therapeutic agents. However, there exists a dearth of data analysis pertaining to drug trials and their progression over the previous decade. 
Figure 1.
Main mechanisms of therapeutic agents for prostate cancer.
Table 1.
Drugs and their mechanisms of actions against prostate cancer.
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