Prevention of bone metatasis in prostate cancer by denosumab: Unneeded endpoint or unmet need?

Targeting bone metastases in prostate cancer (PCa) is a major goal since bone metastases are present in >90% of advanced PCa patients causing significant morbidity and mortality (1). Treatment strategies used for “bone targeted” therapies including bisphosphonates and radionuclides mainly focused on the treatment of existing bone metastases and were not deemed to delay the development and formation of new bone metastases. Preclinical evidence suggests that the RANK-Ligand plays an important role for the development of bone metastasis by influencing cell migration and the tissue-specific metastatic behavior of cancer cells. Targeting the RANK-Ligand may therefore be effective in preventing the development of new bone metastases in prostate cancer patients (2).