Denosumab: Delay of bone metastasis in men with nonmetastatic

In a large multicenter phase 3 randomized controlled trial published in Lancet, Smith and colleagues highlight a potential new indication for denosumab for patients with hormone refractory prostate cancer (1). Already approved for prevention of skeletal-related events in the setting of bone metastases in solid tumors (Xgeva) and prevention of androgen deprivation therapy (ADT) induced bone loss (Prolia), the authors theorized that denosumab administered prior to bone metastasis might stabilize the bone microenvironment thus delaying time to first bone metastasis. Men with castrate-resistant nonmetastatic prostate cancer treated with denosumab showed improved bone-metastasis-free survival and delayed time to first bone metastasis compared to those dosed with placebo.