Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press26810.17650/1994-4098-2010-0-4-43-48PHARMACOTHERAPYГИНЕКОЛОГИЯ. ФАРМАКОТЕРАПИЯTarget approach to treating osseous system pathologyТаргетный подход в лечении патологии костной системыSteninaM. B.СтенинаМ. Б.
Russian Federation
mstenina@mail.ruPetrovaA. D.ПетроваА. Д.
Russian Federation
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowГУ РОНЦ им. Н.Н. Блохина РАМН, Москва291120104434829082014290820142010https://ojrs.abvpress.ru/ojrs/article/view/268

ВTo maintain the normal status of the osseous system in cancer patients is an important task of practical oncology as the complications associated with skeletal pathology substantially worsen quality of life in the patients, increase the cost of treatment, and can affect their lifespan. Osseous complications must be prevented not only in patients with skeletal metastatic lesion, but also in healthy individuals cured from cancer, who may have a significant reduction in bone density (osteoporosis) as a complication due to antitumor therapy. Along with bisphosphonates that are well-known and traditionally used in this situation, there have today been target drugs (denosumab) that can be effective in monitoring the osseous system and preventing the complications of osteoporosis and skeletal metastatic lesion.

Поддержание нормального состояния костной системы у онкологических больных – важная задача практической онкологии, так как осложнения, связанные с патологией скелета, существенно ухудшают качество жизни пациентов, повышают стоимость лечения и могут влиять на продолжительность жизни больных. Профилактика костных осложнений должна осуществляться не только у пациентов с метастатическим поражением скелета, но и у здоровых лиц, излеченных от рака, у которых может иметь место выраженное снижение плотности костной ткани (остеопороз) как осложнение противоопухолевой терапии. Наряду с хорошо известными и традиционно использующимися в этой ситуации бисфосфонатами сегодня появились препараты таргетной направленности (деносумаб), позволяющие эффективно контролировать состояние костной системы и проводить профилактику осложнений остеопороза и метастатического поражения скелета.

osteoblastsosteoclastsbone metabolismbone metastasesosteoporosisdenosumabостеобластыостеокластыкостный обменкостные метастазыостеопорозденосумаб1. Hortobagyi G.N. Systemic therapy for bone metastasis: past, present and future. Educational Book Articles. ASCO, 2010; p. 3–7.Hortobagyi G.N. Systemic therapy for bone metastasis: past, present and future. Educational Book Articles. ASCO, 2010; p. 3–7.2. Roodman G.D. Mechanisms of disease: mechanisms of bone metastasis. New Engl J Med 2004;16:1655–64.Roodman G.D. Mechanisms of disease: mechanisms of bone metastasis. New Engl J Med 2004;16:1655–64.3. Body J.J., Greipp P., Coleman R.E. et al. A phase I study of AMGN-0007, a recombinant osteoprotegerin construct, in patients with multiple myeloma or breast carcinoma related bone metastases. Cancer 2003;97(Suppl):887–92.Body J.J., Greipp P., Coleman R.E. et al. A phase I study of AMGN-0007, a recombinant osteoprotegerin construct, in patients with multiple myeloma or breast carcinoma related bone metastases. Cancer 2003;97(Suppl):887–92.4. Boyle W.J., Simonet W.S., Lacey D.L. et al. Osteoclast differentiation and activation. Nature 2003;423:337–42.Boyle W.J., Simonet W.S., Lacey D.L. et al. Osteoclast differentiation and activation. Nature 2003;423:337–42.5. George S., Brenner A., Sarantopoulos J. et al. RANK Ligand: effects of inhibition. Curr Oncol Rep 2010;12:80–6.George S., Brenner A., Sarantopoulos J. et al. RANK Ligand: effects of inhibition. Curr Oncol Rep 2010;12:80–6.6. Lipton A., Steger G.G., Figueroa J. et al. Randomized active-controlled phase II study of denosumab efficacy and safety in patients with breast cancer-related bone metastases. J Clin Oncol 2007;25:4431–7.Lipton A., Steger G.G., Figueroa J. et al. Randomized active-controlled phase II study of denosumab efficacy and safety in patients with breast cancer-related bone metastases. J Clin Oncol 2007;25:4431–7.7. Stopeck A., De Boer R., Fujiwara Y. et al. A comparison of denosumab versus zoledronic acid for the prevention of skeletal-related events in breast cancer patients with bone metastases [abstract 22]. Cancer Res 2009;69 (Suppl 1):490.Stopeck A., De Boer R., Fujiwara Y. et al. A comparison of denosumab versus zoledronic acid for the prevention of skeletal-related events in breast cancer patients with bone metastases [abstract 22]. Cancer Res 2009;69 (Suppl 1):490.8. Lipton A., Stopeck A., von Moos R.A. Meta-analysis of results from two randomized, double-blind studies of denosumab versus zoledronic acid (ZA) for treatment of bone metastases. J Clin Oncol 2010;28 (Suppl):15.Lipton A., Stopeck A., von Moos R.A. Meta-analysis of results from two randomized, double-blind studies of denosumab versus zoledronic acid (ZA) for treatment of bone metastases. J Clin Oncol 2010;28 (Suppl):15.Abstr 9015.9. Ellis G.K., Bone H.G., Chlebowski R. et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J Clin Oncol 2008;26:4875–82.Ellis G.K., Bone H.G., Chlebowski R. et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J Clin Oncol 2008;26:4875–82.10. Cummings S.R., Martin J.S., McClung M.R. et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. New Engl J Med 2009;361:756–65.Cummings S.R., Martin J.S., McClung M.R. et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. New Engl J Med 2009;361:756–65.11. Smith M.R., Egerdie B., Toriz N.H. et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. New Engl J Med 2009;361:745–55.Smith M.R., Egerdie B., Toriz N.H. et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. New Engl J Med 2009;361:745–55.12. Gauthier J.Y., Chauret N., Cromlish W. et al. The discovery of odanacatib (MK- 0822), a selective inhibitor of cathepsin K. Bioorg Med Chem Letters 2008;18:923–8.Gauthier J.Y., Chauret N., Cromlish W. et al. The discovery of odanacatib (MK- 0822), a selective inhibitor of cathepsin K. Bioorg Med Chem Letters 2008;18:923–8.13. Harms J.F., Welch D.R., Samant R.S. et al. A small molecule antagonist of the alpha (v) beta-3 integrin suppresses MDA- MB-435 skeletal metastasis. Clin Exp Metastas 2004;21:119–28.Harms J.F., Welch D.R., Samant R.S. et al. A small molecule antagonist of the alpha (v) beta-3 integrin suppresses MDA- MB-435 skeletal metastasis. Clin Exp Metastas 2004;21:119–28.14. Murphy M.G., Cerchio K., Stoch S.A. et al. Effect of L-000845704, an alpha-V- beta-3 integrin antagonist, on markers of bone turnover and bone mineral density in postmenopausal osteoporotic women. J Clin Endocrinol Metab 2005;90:2022–8.Murphy M.G., Cerchio K., Stoch S.A. et al. Effect of L-000845704, an alpha-V- beta-3 integrin antagonist, on markers of bone turnover and bone mineral density in postmenopausal osteoporotic women. J Clin Endocrinol Metab 2005;90:2022–8.