Bone Metastasis from Renal Cell Carcinoma

被引:55
作者
Chen, Szu-Chia [1 ,2 ,3 ,4 ]
Kuo, Po-Lin [1 ,5 ]
机构
[1] Kaohsiung Med Univ, Coll Med, Grad Inst Clin Med, Kaohsiung 807, Taiwan
[2] Kaohsiung Med Univ, Dept Internal Med, Div Nephrol, Kaohsiung Med Univ Hosp, Kaohsiung 807, Taiwan
[3] Kaohsiung Med Univ, Dept Internal Med, Kaohsiung Municipal Hsiao Kang Hosp, Kaohsiung 812, Taiwan
[4] Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung 807, Taiwan
[5] Natl Sun Yat Sen Univ, Inst Med Sci & Technol, Kaohsiung 804, Taiwan
关键词
renal cell carcinoma; bone metastasis; molecular mechanisms; bone turnover markers; therapies; HORMONE-RELATED PROTEIN; TRANSFORMING-GROWTH-FACTOR; SKELETAL-RELATED EVENTS; CALCIUM-SENSING RECEPTOR; HUMAN-BREAST-CANCER; ZOLEDRONIC ACID; PROSTATE-CANCER; DOUBLE-BLIND; BIOCHEMICAL MARKERS; PROGNOSTIC-FACTORS;
D O I
10.3390/ijms17060987
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
About one-third of patients with advanced renal cell carcinoma (RCC) have bone metastasis that are often osteolytic and cause substantial morbidity, such as pain, pathologic fracture, spinal cord compression and hypercalcemia. The presence of bone metastasis in RCC is also associated with poor prognosis. Bone-targeted treatment using bisphosphonate and denosumab can reduce skeletal complications in RCC, but does not cure the disease or improve survival. Elucidating the molecular mechanisms of tumor-induced changes in the bone microenvironment is needed to develop effective treatment. The "vicious cycle" hypothesis has been used to describe how tumor cells interact with the bone microenvironment to drive bone destruction and tumor growth. Tumor cells secrete factors like parathyroid hormone-related peptide, transforming growth factor-beta and vascular endothelial growth factor, which stimulate osteoblasts and increase the production of the receptor activator of nuclear factor kappa B ligand (RANKL). In turn, the overexpression of RANKL leads to increased osteoclast formation, activation and survival, thereby enhancing bone resorption. This review presents a general survey on bone metastasis in RCC by natural history, interaction among the immune system, bone and tumor, molecular mechanisms, bone turnover markers, therapies and healthcare burden.
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页数:18
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