Use of bisphosphonates in oncology

Bone is the third most common site involved by metastasis, behind lung and liver. Bone metastases occur in almost all tumors and may be classified as osteolytic, osteoblastic, or mixed, according to the primary mechanism of interference with normal bone remodeling. In many cases, both osteolytic and osteoblastic processes are affected. The main goals in the management of patients with bone metastases are to treat the underlying malignancy and to intervene such that skeletal complications are avoided. Therapeutic options include surgery, radiation, chemotherapy, hormonal and biologically targeted therapies, and bisphosphonates. To date, bisphosphonates are the primary treatment option for reducing, delaying, and preventing the skeletal complications associated with bone metastases, thus maintaining and restoring patients' mobility and function and reducing pain. The mechanism of bisphosphonates action and the use of these drugs in breast, prostate, lung, kidney, bladder, and thyroid cancers are described.