Markers of Bone Remodeling in Metastatic Bone Disease

Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in bone metabolism, once bony metastases have occurred, are usually profound. This review surveys the usefulness of bone markers in the diagnosis...

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Published in	The journal of clinical endocrinology and metabolism Vol. 88; no. 11; pp. 5059 - 5075
Main Authors	Fohr, Berthold, Dunstan, Colin R, Seibel, Markus J
Format	Journal Article
Language	English
Published	Bethesda, MD Endocrine Society 01.11.2003 Copyright by The Endocrine Society
Subjects	Biological and medical sciences Diseases of the osteoarticular system Medical sciences Miscellaneous. Osteoarticular involvement in other diseases Antineoplastic agent Chemotherapy Biological marker Bone disease Malignant tumor Diagnosis Metastasis Bone Bone remodeling Osseous tissue Monitoring Bibliographic review
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Abstract	Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in bone metabolism, once bony metastases have occurred, are usually profound. This review surveys the usefulness of bone markers in the diagnosis and follow-up of patients with malignant bone disease. In patients with established bone metastases, most markers of bone remodeling are abnormal compared with healthy controls or cancer patients without bone lesions. Although bone markers may have a potential as diagnostic tools in cancer patients, the available data do not allow final conclusions regarding the accuracy and validity of any of the presently used markers in the diagnosis of bone metastases. As regards monitoring of anticancer therapy, most markers of bone remodeling respond to active treatments. These indices therefore may have the potential to be used in the monitoring of antitumor therapies. However, most if not all of the available evidence on the use of bone markers in monitoring anticancer therapy is observational, and it remains unclear whether they have any beneficial effects on overall outcome. The same is true for their prognostic value, although evidence suggests that suppressed levels of bone formation or high rates of bone resorption are independent predictors of poor survival.
AbstractList	Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in bone metabolism, once bony metastases have occurred, are usually profound. This review surveys the usefulness of bone markers in the diagnosis and follow-up of patients with malignant bone disease. In patients with established bone metastases, most markers of bone remodeling are abnormal compared with healthy controls or cancer patients without bone lesions. Although bone markers may have a potential as diagnostic tools in cancer patients, the available data do not allow final conclusions regarding the accuracy and validity of any of the presently used markers in the diagnosis of bone metastases. As regards monitoring of anticancer therapy, most markers of bone remodeling respond to active treatments. These indices therefore may have the potential to be used in the monitoring of antitumor therapies. However, most if not all of the available evidence on the use of bone markers in monitoring anticancer therapy is observational, and it remains unclear whether they have any beneficial effects on overall outcome. The same is true for their prognostic value, although evidence suggests that suppressed levels of bone formation or high rates of bone resorption are independent predictors of poor survival. Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in bone metabolism, once bony metastases have occurred, are usually profound. This review surveys the usefulness of bone markers in the diagnosis and follow-up of patients with malignant bone disease. In patients with established bone metastases, most markers of bone remodeling are abnormal compared with healthy controls or cancer patients without bone lesions. Although bone markers may have a potential as diagnostic tools in cancer patients, the available data do not allow final conclusions regarding the accuracy and validity of any of the presently used markers in the diagnosis of bone metastases. As regards monitoring of anticancer therapy, most markers of bone remodeling respond to active treatments. These indices therefore may have the potential to be used in the monitoring of antitumor therapies. However, most if not all of the available evidence on the use of bone markers in monitoring anticancer therapy is observational, and it remains unclear whether they have any beneficial effects on overall outcome. The same is true for their prognostic value, although evidence suggests that suppressed levels of bone formation or high rates of bone resorption are independent predictors of poor survival.
Author	Seibel, Markus J Dunstan, Colin R Fohr, Berthold
AuthorAffiliation	Department of Medicine (B.F.), University of Heidelberg, D-69117 Heidelberg, Germany; and Bone Research Program, ANZAC Research Institute, and Department of Endocrinology, Concord Hospital Medical Centre (C.R.D., M.J.S.), University of Sydney, Sydney 2139, New South Wales, Australia
AuthorAffiliation_xml	– name: Department of Medicine (B.F.), University of Heidelberg, D-69117 Heidelberg, Germany; and Bone Research Program, ANZAC Research Institute, and Department of Endocrinology, Concord Hospital Medical Centre (C.R.D., M.J.S.), University of Sydney, Sydney 2139, New South Wales, Australia
Author_xml	– sequence: 1 givenname: Berthold surname: Fohr fullname: Fohr, Berthold – sequence: 2 givenname: Colin R surname: Dunstan fullname: Dunstan, Colin R – sequence: 3 givenname: Markus J surname: Seibel fullname: Seibel, Markus J
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Snippet	Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in...
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SubjectTerms	Biological and medical sciences Diseases of the osteoarticular system Medical sciences Miscellaneous. Osteoarticular involvement in other diseases
Title	Markers of Bone Remodeling in Metastatic Bone Disease
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