Περίληψη:
Bone is the most frequent site of metastases of prostate cancer and is
almost always the first and frequently the only site of metastases where
disease will progress to stage D3. In addition, the number of skeletal
metastatic foci is the most powerful independent prognostic factor of
limited response to hormone ablation therapy and poor survival of
patients with advanced prostate cancer. Furthermore, disease progression
frequently occurs in the osteoblastic metastases, even though androgen
ablation therapy still provides adequate and sustained control of
disease at the primary site. Notably, the management of metastatic
disease onto bones has traditionally relied on therapeutic modalities,
which almost exclusively aim at directly inducing cancer cell death.
However, accumulating pieces of evidence, from both the clinical and the
basic research front, point to major limitations of this conventional
approach. The in vivo response of malignant cells to anticancer
therapies is directly influenced by the local microenvironment in which
they metastasize. In particular, organ sites frequently. involved in
metastatic diseases, such as the bones, appear to confer to metastatic
cells protection from anticancer drug-induced apoptosis. This protection
is mediated by soluble growth factors and cytokines released by the
normal cellular constituents of the host tissue microenvironment. The
characterization of bone microenvironment-related survival factors has
led to the development of a novel hormone manipulation which can
re-introduce clinical responses in patients with stage D3 prostate
cancer.
Συγγραφείς:
Bogdanos, J
Karamanolakis, D
Tenta, R
Tsintavis, A and
Milathianakis, C
Mitsiades, C
Koutsilieris, M
