Abstract
Drugs used to treat cancer may affect the skeleton in several ways, the most important being a decrease in sex steroid levels. This may induce rapid bone loss. Tamoxifen is a partial oestrogen receptor agonist and antagonist (classified as a selective oestrogen receptor modulator or SERM). As it has agonistic effects on oestrogen receptors of bone it increases bone mineral density and thus may potentially prevent fractures. In contrast aromatase inhibitors such as anastrozole lead to a decrease in bone mineral density and an increased risk of fractures. Most high-dose intravenous chemotherapeutic regimens induce rapid bone loss from effects on the gonads with induction, for example, of premature menopause. Low-dose oral agents such as methotrexate are not associated with an increased risk of fractures. Androgen deprivation therapies such as LHRH agonists in breast cancer are also associated with an increase in bone loss and an increased risk of fractures. With the increasing long-term survival of patients with cancer, preventive measures against osteoporosis must be considered.
Keywords: Skeletal Effects of Drugs, Cancer, sex steroid levels, Tamoxifen, bone mineral density, aromatase inhibitors, osteoporosis, antagonist
Current Drug Safety
Title: Skeletal Effects of Drugs to Treat Cancer
Volume: 3 Issue: 3
Author(s): Peter Vestergaard
Affiliation:
Keywords: Skeletal Effects of Drugs, Cancer, sex steroid levels, Tamoxifen, bone mineral density, aromatase inhibitors, osteoporosis, antagonist
Abstract: Drugs used to treat cancer may affect the skeleton in several ways, the most important being a decrease in sex steroid levels. This may induce rapid bone loss. Tamoxifen is a partial oestrogen receptor agonist and antagonist (classified as a selective oestrogen receptor modulator or SERM). As it has agonistic effects on oestrogen receptors of bone it increases bone mineral density and thus may potentially prevent fractures. In contrast aromatase inhibitors such as anastrozole lead to a decrease in bone mineral density and an increased risk of fractures. Most high-dose intravenous chemotherapeutic regimens induce rapid bone loss from effects on the gonads with induction, for example, of premature menopause. Low-dose oral agents such as methotrexate are not associated with an increased risk of fractures. Androgen deprivation therapies such as LHRH agonists in breast cancer are also associated with an increase in bone loss and an increased risk of fractures. With the increasing long-term survival of patients with cancer, preventive measures against osteoporosis must be considered.
Export Options
About this article
Cite this article as:
Vestergaard Peter, Skeletal Effects of Drugs to Treat Cancer, Current Drug Safety 2008; 3 (3) . https://dx.doi.org/10.2174/157488608785699522
DOI https://dx.doi.org/10.2174/157488608785699522 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Interleukin-21 in Immune and Allergic Diseases
Inflammation & Allergy - Drug Targets (Discontinued) Phytochemical Analysis with Antioxidant and Cytotoxicity Studies of the Bioactive Principles from Zanthoxylum capense (Small Knobwood)
Anti-Cancer Agents in Medicinal Chemistry Bisphosphonates in Lung Cancer: Can They Provide Benefits Beyond Prevention of Skeletal Morbidity?
Anti-Cancer Agents in Medicinal Chemistry Editorial (Thematic Issue: Effective and Promising Treatments for Neurological Disorders and Cancer)
Current Pharmaceutical Design Nano-Based Therapy for Treatment of Skin Cancer
Recent Patents on Anti-Infective Drug Discovery Status of Anti-Lung Cancer Drug Patents Applications in China from 2003 to 2012
Recent Patents on Anti-Cancer Drug Discovery Evaluation of <sup>177</sup>Lu-EDTMP in Dogs with Spontaneous Tumor Involving Bone: Pharmacokinetics, Dosimetry and Therapeutic Efficacy
Current Radiopharmaceuticals Encouraging microRNA-based Therapeutic Strategies for Hepatocellular Carcinoma
Anti-Cancer Agents in Medicinal Chemistry Editorial (Thematic Issue: Novel Methods and Tools of the Computational Systems Biology in Bioinformatics and Biomedical Informatics)
Current Bioinformatics Circulating Levels of Soluble Angiogenic Factors in Multiple Myeloma: Correlation with Parameters of Disease Activity and Prognosis
Current Angiogenesis (Discontinued) Lessons in Medical Record Abstraction from the Prostate, Lung, Colorectal, and Ovarian (PLCO) National Screening Trial
Reviews on Recent Clinical Trials Overview of Flaxseed Patent Applications for the Reduction of Cholesterol Levels
Recent Patents on Food, Nutrition & Agriculture VIP in Inflammatory Bowel Disease: State of the Art
Endocrine, Metabolic & Immune Disorders - Drug Targets Nucleic Acid-Based Aptamers: Applications, Development and Clinical Trials
Current Medicinal Chemistry Disseminated Intravascular Coagulation in Leukemia and Sepsis
Vascular Disease Prevention (Discontinued) Withdrawal Notice: TP53 Targetome: A Database of Novel Breast Cancer Biomarkers
Current Drug Targets Recent Progress of Src Family Kinase Inhibitors as Anticancer Agents
Mini-Reviews in Medicinal Chemistry Activities of Venom Proteins and Peptides with Possible Therapeutic Applications from Bees and WASPS
Protein & Peptide Letters Multidisciplinary Approach to Rectal Cancer: Are we Ready for Selective Treatment Strategies?
Anti-Cancer Agents in Medicinal Chemistry Synergistic Interplay of Medicinal Chemistry and Formulation Strategies in Nanotechnology – From Drug Discovery to Nanocarrier Design and Development
Current Topics in Medicinal Chemistry