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      Is Open Access

      The role of biomarkers in the management of bone-homing malignancies

      review-article
      , , *
      Journal of Bone Oncology
      Elsevier
      BM, bone metastases, SREs, skeletal related events, BTM, bone turnover markers, P1NP and P1CP, N and C terminal pro-peptides of type 1 collagen, BALP, bone specific alkaline phosphatase, TRACP-5b, tartrate-resistant acid phosphatase type 5b, NTX and CTX, N- and C- telopeptides of type 1 collagen, RANK, receptor activator of nuclear factor kB, RANK-L, RANK-ligand, OPG, osteoprotegerin, TNF, tumour necrosis factor, IL, interleukin, M-CSF, macrophage colony stimulating factor, PTH, parathyroid hormone, TGF-β, transforming growth factor-β, VEGF, vascular endothelial growth factor, PlGF, placental growth factor, BMDC, bone marrow derived cells, EMT, epithelial to mesenchymal transition, CXCR, C–X–C motif chemokine receptor, CXCL, C–X–C motif chemokine ligand, SDF-1, stromal cell-derived factor 1, CaSR, calcium sensing receptor, BC, breast cancer, DTC, disseminated tumour cells, PTH-rP, PTH related protein, IGF, insulin-like growth factor, PDGF, platelet-derived growth factor, PC, prostate cancer, BMPs, bone morphogenetic proteins, FGF, fibroblast growth factor, ER, estrogen receptor, Her2, human epidermal growth factor receptor 2, HR, hormone receptor, IL-1R, IL-1 receptor, ZNF217, zinc-finger protein 217, MAF, v-maf avian musculo-aponeurotic fibrosarcoma oncogene homolog, miRNA, micro RNA, TRAF3, TNF receptor associated factor 3, BSP, bone sialoprotein, CCL2, chemokine C-C ligand 2, CAPG, macrophage-capping protein, GIPC1, PDZ domain–containing protein member 1, PSA, prostate specific antigen, PDGFRα, PDGF receptor α, shRNA, short hairpin RNA, CTC, circulating tumour cells, LC, lung cancer, NSCLC, non-small cell LC, PYD, pyridinoline, DPD, deoxypyridinoline, uNTX, urinary NTX, β-CTX, CTX β isomer, 1CTP, cross-linked carboxy-terminal telopeptide of type 1 collagen, sBALP, serum BALP, BTA, bone-targeting agents, Bone metastasis, Biomarkers, Bone turnover markers, Breast cancer, Prostate cancer, Lung cancer

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          Abstract

          Bone represents a common site of metastasis from several solid tumours, including breast, prostate and lung malignancies. The onset of bone metastases (BM) is associated not only with serious skeletal complications, but also shortened overall survival, owing to the lack of curative treatment options for late-stage cancer.

          Despite the diagnostic advances, BM detection often occurs in the symptomatic stage, underlining the need for novel strategies aimed at the early identification of high-risk patients. To this purpose, both bone turnover and tumour-derived markers are being investigated for their potential diagnostic, prognostic and predictive roles.

          In this review, we summarize the pathogenesis of BM in breast, prostate and lung tumours, while exploring the current research focused on the identification and clinical validation of BM biomarkers.

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          Most cited references74

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          Circulating tumor cells predict survival benefit from treatment in metastatic castration-resistant prostate cancer.

          A method for enumerating circulating tumor cells (CTC) has received regulatory clearance. The primary objective of this prospective study was to establish the relationship between posttreatment CTC count and overall survival (OS) in castration-resistant prostate cancer (CRPC). Secondary objectives included determining the prognostic utility of CTC measurement before initiating therapy, and the relationship of CTC to prostate-specific antigen (PSA) changes and OS at these and other time points. Blood was drawn from CRPC patients with progressive disease starting a new line of chemotherapy before treatment and monthly thereafter. Patients were stratified into predetermined Favorable or Unfavorable groups ( or =5 CTC/7.5mL). Two hundred thirty-one of 276 enrolled patients (84%) were evaluable. Patients with Unfavorable pretreatment CTC (57%) had shorter OS (median OS, 11.5 versus 21.7 months; Cox hazard ratio, 3.3; P 26 to 9.3 months). CTC are the most accurate and independent predictor of OS in CRPC. These data led to Food and Drug Administration clearance of this assay for the evaluation of CRPC.
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            Circulating tumor cell number and prognosis in progressive castration-resistant prostate cancer.

            The development of tumor-specific markers to select targeted therapies and to assess clinical outcome remains a significant area of unmet need. We evaluated the association of baseline circulating tumor cell (CTC) number with clinical characteristics and survival in patients with castrate metastatic disease considered for different hormonal and cytotoxic therapies. CTC were isolated by immunomagnetic capture from 7.5-mL samples of blood from 120 patients with progressive clinical castrate metastatic disease. We estimated the probability of survival over time by the Kaplan-Meier method. The concordance probability estimate was used to gauge the discriminatory strength of the informative prognostic factors. Sixty-nine (57%) patients had five or more CTC whereas 30 (25%) had two cells or less. Higher CTC numbers were observed in patients with bone metastases relative to those with soft tissue disease and in patients who had received prior cytotoxic chemotherapy relative to those who had not. CTC counts were modestly correlated to measurements of tumor burden such as prostate-specific antigen and bone scan index, reflecting the percentage of boney skeleton involved with tumor. Baseline CTC number was strongly associated with survival, without a threshold effect, which increased further when baseline prostate-specific antigen and albumin were included. Baseline CTC was predictive of survival, with no threshold effect. The shedding of cells into the circulation represents an intrinsic property of the tumor, distinct from extent of disease, and provides unique information relative to prognosis.
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              The pre-metastatic niche: finding common ground.

              It is rapidly becoming evident that the formation of tumor-promoting pre-metastatic niches in secondary organs adds a previously unrecognized degree of complexity to the challenge of curing metastatic disease. Primary tumor cells orchestrate pre-metastatic niche formation through secretion of a variety of cytokines and growth factors that promote mobilization and recruitment of bone marrow-derived cells to future metastatic sites. Hypoxia within the primary tumor, and secretion of specific microvesicles termed exosomes, are emerging as important processes and vehicles for tumor-derived factors to modulate pre-metastatic sites. It has also come to light that reduced immune surveillance is a novel mechanism through which primary tumors create favorable niches in secondary organs. This review provides an overview of our current understanding of underlying mechanisms of pre-metastatic niche formation and highlights the common links as well as discrepancies between independent studies. Furthermore, the possible clinical implications, links to metastatic persistence and dormancy, and novel approaches for treatment of metastatic disease through reversal of pre-metastatic niche formation are identified and explored.
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                Author and article information

                Contributors
                Journal
                J Bone Oncol
                J Bone Oncol
                Journal of Bone Oncology
                Elsevier
                2212-1366
                2212-1374
                11 September 2017
                November 2017
                11 September 2017
                : 9
                : 1-9
                Affiliations
                [0005]Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Whitham Road, Sheffield S10 2S, England, UK
                Author notes
                [* ]Corresponding author. r.e.coleman@ 123456sheffield.ac.uk
                Article
                S2212-1374(17)30077-5
                10.1016/j.jbo.2017.09.001
                5602513
                28948139
                2f1758e2-7536-45b4-8ffe-cdc5c0ad1048
                © 2017 Published by Elsevier GmbH.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 19 July 2017
                : 4 September 2017
                : 5 September 2017
                Categories
                Review Article

                bm, bone metastases,sres, skeletal related events,btm, bone turnover markers,p1np and p1cp, n and c terminal pro-peptides of type 1 collagen,balp, bone specific alkaline phosphatase,tracp-5b, tartrate-resistant acid phosphatase type 5b,ntx and ctx, n- and c- telopeptides of type 1 collagen,rank, receptor activator of nuclear factor kb,rank-l, rank-ligand,opg, osteoprotegerin,tnf, tumour necrosis factor,il, interleukin,m-csf, macrophage colony stimulating factor,pth, parathyroid hormone,tgf-β, transforming growth factor-β,vegf, vascular endothelial growth factor,plgf, placental growth factor,bmdc, bone marrow derived cells,emt, epithelial to mesenchymal transition,cxcr, c–x–c motif chemokine receptor,cxcl, c–x–c motif chemokine ligand,sdf-1, stromal cell-derived factor 1,casr, calcium sensing receptor,bc, breast cancer,dtc, disseminated tumour cells,pth-rp, pth related protein,igf, insulin-like growth factor,pdgf, platelet-derived growth factor,pc, prostate cancer,bmps, bone morphogenetic proteins,fgf, fibroblast growth factor,er, estrogen receptor,her2, human epidermal growth factor receptor 2,hr, hormone receptor,il-1r, il-1 receptor,znf217, zinc-finger protein 217,maf, v-maf avian musculo-aponeurotic fibrosarcoma oncogene homolog,mirna, micro rna,traf3, tnf receptor associated factor 3,bsp, bone sialoprotein,ccl2, chemokine c-c ligand 2,capg, macrophage-capping protein,gipc1, pdz domain–containing protein member 1,psa, prostate specific antigen,pdgfrα, pdgf receptor α,shrna, short hairpin rna,ctc, circulating tumour cells,lc, lung cancer,nsclc, non-small cell lc,pyd, pyridinoline,dpd, deoxypyridinoline,untx, urinary ntx,β-ctx, ctx β isomer,1ctp, cross-linked carboxy-terminal telopeptide of type 1 collagen,sbalp, serum balp,bta, bone-targeting agents,bone metastasis,biomarkers,bone turnover markers,breast cancer,prostate cancer,lung cancer
                bm, bone metastases, sres, skeletal related events, btm, bone turnover markers, p1np and p1cp, n and c terminal pro-peptides of type 1 collagen, balp, bone specific alkaline phosphatase, tracp-5b, tartrate-resistant acid phosphatase type 5b, ntx and ctx, n- and c- telopeptides of type 1 collagen, rank, receptor activator of nuclear factor kb, rank-l, rank-ligand, opg, osteoprotegerin, tnf, tumour necrosis factor, il, interleukin, m-csf, macrophage colony stimulating factor, pth, parathyroid hormone, tgf-β, transforming growth factor-β, vegf, vascular endothelial growth factor, plgf, placental growth factor, bmdc, bone marrow derived cells, emt, epithelial to mesenchymal transition, cxcr, c–x–c motif chemokine receptor, cxcl, c–x–c motif chemokine ligand, sdf-1, stromal cell-derived factor 1, casr, calcium sensing receptor, bc, breast cancer, dtc, disseminated tumour cells, pth-rp, pth related protein, igf, insulin-like growth factor, pdgf, platelet-derived growth factor, pc, prostate cancer, bmps, bone morphogenetic proteins, fgf, fibroblast growth factor, er, estrogen receptor, her2, human epidermal growth factor receptor 2, hr, hormone receptor, il-1r, il-1 receptor, znf217, zinc-finger protein 217, maf, v-maf avian musculo-aponeurotic fibrosarcoma oncogene homolog, mirna, micro rna, traf3, tnf receptor associated factor 3, bsp, bone sialoprotein, ccl2, chemokine c-c ligand 2, capg, macrophage-capping protein, gipc1, pdz domain–containing protein member 1, psa, prostate specific antigen, pdgfrα, pdgf receptor α, shrna, short hairpin rna, ctc, circulating tumour cells, lc, lung cancer, nsclc, non-small cell lc, pyd, pyridinoline, dpd, deoxypyridinoline, untx, urinary ntx, β-ctx, ctx β isomer, 1ctp, cross-linked carboxy-terminal telopeptide of type 1 collagen, sbalp, serum balp, bta, bone-targeting agents, bone metastasis, biomarkers, bone turnover markers, breast cancer, prostate cancer, lung cancer

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