Management of bone metastases in refractory prostate cancer – role of denosumab

Figures & data

Table 1 Prostate cancer clinical states model for metastatic, castration-resistant prostate cancer

State	Recently approved treatments	Positive phase III trial results
Rising PSA: castration-resistant	None	None
Metastatic castration-resistant 1st line therapy	Docetaxel, sipuleucel-T, zoledronic acid,** denosumab**	Abiraterone,^Citation6 alpharadin^Citation7,*
Metastatic castration-resistant post-docetaxel	Cabazitaxel, abiraterone, zoledronic acid,** denosumab**	Enzalutamide,^Citation8 alpharadin^Citation7

Notes:

* Patients who refused or were ineligible for docetaxel;

** approved treatment of patients with documented bone metastases, not for survival.

Abbreviation: PSA, prostate-specific antigen.

Figure 1 Mechanism of action of denosumab.

Note: Copyright© 2012. Nature Publishing Group. Reproduced with permission from Lewiecki EM, Bilezikian JP. Denosumab for the treatment of osteoporosis and cancer-related conditions. Clin Pharmacol Ther. 2012;91(1):123–133.⁴³
Abbreviations: RANKL, receptor activator of nuclear factor-κB legends; RANK, receptor activator of nuclear factor-κB.

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