Kyle O. Rove, MD

This review will examine agents with potential activity in the palliation and treatment of skeletal metastases of prostate cancer, and will weigh the clinical-outcomes evidence for and against their broad use.

Prostate cancer will be diagnosed in one of six men during their lifetimes, and a small portion of these will progress after primary and salvage therapies. For many years, there were few treatment options for these patients after routine hormonal maneuvers, and standard of care since the early 2000s has consisted primarily of docetaxel, which improved survival over the previous first-line therapy mitoxantrone. In recent years, however, new therapies have begun to emerge to treat this devastating form of prostate cancer. This review examines the mechanisms behind these therapeutics and the key trials seeking to validate their clinical use.

More than 50% of patients with advanced breast or prostate cancer have identifiable bone metastasis, and 30% to 40% of patients with non–small-cell lung cancer ultimately develop metastases to bone.[1,2]