Novel approaches to target the microenvironment of bone metastasis

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

Abstract

Bone metastases are a frequent and severe complication of advanced-stage cancers. Breast and prostate cancers, the most common malignancies in women and men, respectively, have a particularly high propensity to metastasize to bone. Conceptually, circulating tumour cells (CTCs) in the bloodstream and disseminated tumour cells (DTCs) in the bone marrow provide a snapshot of the dissemination and colonization process en route to clinically apparent bone metastases. Many cell types that constitute the bone microenvironment, including osteoblasts, osteocytes, osteoclasts, adipocytes, endothelial cells, haematopoietic stem cells and immune cells, engage in a dialogue with tumour cells. Some of these cells modify tumour biology, while others are disrupted and out-competed by tumour cells, thus leading to distinct phases of tumour cell migration, dormancy and latency, and therapy resistance and progression to overt bone metastases. Several current bone-protective therapies act by interrupting these interactions, mainly by targeting tumour cell-osteoclast interactions. In this Review, we describe the functional roles of the bone microenvironment and its components in the initiation and propagation of skeletal metastases, outline the biology and clinical relevance of CTCs and DTCs, and discuss established and future therapeutic approaches that specifically target defined components of the bone microenvironment to prevent or treat skeletal metastases.

Details

Original languageEnglish
Pages (from-to)488-505
Number of pages18
JournalNature reviews. Clinical oncology
Volume18
Issue number8
Publication statusPublished - Aug 2021
Peer-reviewedYes

External IDs

Scopus 85104556390
ORCID /0000-0002-8691-8423/work/142236036

Keywords

Sustainable Development Goals

Keywords

  • Animals, Bone Neoplasms/pathology, Humans, Molecular Targeted Therapy/methods, Neoplasm Metastasis, Neoplastic Cells, Circulating/pathology, Therapies, Investigational/methods, Tumor Microenvironment/drug effects