Treatment of myeloma bone disease: When, how often, and for how long?

IF 3.4 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-04-01 DOI:10.1016/j.jbo.2025.100680

Michael Tveden Gundesen , Fredrik Schjesvold , Thomas Lund

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Abstract

The landscape of MM has changed dramatically in recent years. Several new and more effective treatments have been introduced that not only makes patients live longer but also brings them into a deeper remission. This makes the potential total exposure of bone protective treatment much higher but perhaps also less needed. New and more precise imagining techniques have been introduced making detection of bone disease more sensitive, and the introduction of SLiM-CRAB criteria have changed the parameters used in old clinical trials investigating treatment of MM bone disease. New data have also emerged investigating the effect of the RANKL inhibitor denosumab compared to zoledronic acid (ZOL). Randomized trials have investigated longer treatment durations, which becomes more relevant as patients now live longer.

In addition in this review, data regarding interval between individual treatment, impact of remission status, new data in relation to rebound after discontinuation and of denosumab, as well as the rational for drug holidays before dental procedures will also be discussed.

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骨髓瘤骨病的治疗：何时、多久、持续多久？

近年来，MM的格局发生了巨大变化。一些新的和更有效的治疗方法被引入，不仅使病人活得更长，而且使他们进入更深的缓解。这使得骨保护治疗的潜在总暴露要高得多，但可能也不太需要。新的和更精确的成像技术的引入使骨病的检测更加敏感，SLiM-CRAB标准的引入改变了用于MM骨病治疗的旧临床试验的参数。与唑来膦酸（ZOL）相比，研究RANKL抑制剂denosumab的效果也出现了新的数据。随机试验研究了更长的治疗持续时间，随着患者寿命的延长，这变得更加相关。此外，在本综述中，还将讨论有关个体治疗间隔、缓解状态的影响、停药和denosumab后反弹的新数据，以及牙科手术前药物假期的合理性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.