Bone metastasis and skeletal complications have a devastating impact on the quality of life and are a major cause of morbidity in prostate cancer patients. In addition to established bone-targeted therapies, new drugs such as endothelin A receptor antagonists, MET and VEGFR-2 antagonists or radiopharmaceuticals are in the focus of development. The standard care in prostate cancer patients with bone metastases to prevent skeletal-related events (SRE) are bisphosphonates. Denosumab, a human monoclonal antibody against RANKL, appeared to be superior to zoledronic acid for prevention of SRE and has been shown to prolong bone metastases-free survival. In contrast to zoledronic acid, denosumab clearance is not dependent on kidney function and can be administered subcutaneously. Similar rates of toxicity were observed for both substances; however, long-term data for denosumab are limited.
Bonomi, M., Cerchiaro, E., Villa, E., Setti, L. R., Gianoncelli, L., Micheli, E., & Ceresoli, G. L. (2018). Bone Metastases in Prostate Cancer. In Clinical Applications of Nuclear Medicine Targeted Therapy (pp. 323–343). Springer International Publishing. https://doi.org/10.1007/978-3-319-63067-0_25