Novel approaches to target the microenvironment of bone metastasis

TY - JOUR

T1 - Novel approaches to target the microenvironment of bone metastasis

AU - Hofbauer, Lorenz C

AU - Bozec, Aline

AU - Rauner, Martina

AU - Jakob, Franz

AU - Perner, Sven

AU - Pantel, Klaus

N1 - © 2021. Springer Nature Limited.

PY - 2021/8

Y1 - 2021/8

N2 - Bone metastases are a frequent and severe complication of advanced-stage cancers. Breast and prostate cancers, the most common malignancies in women and men, respectively, have a particularly high propensity to metastasize to bone. Conceptually, circulating tumour cells (CTCs) in the bloodstream and disseminated tumour cells (DTCs) in the bone marrow provide a snapshot of the dissemination and colonization process en route to clinically apparent bone metastases. Many cell types that constitute the bone microenvironment, including osteoblasts, osteocytes, osteoclasts, adipocytes, endothelial cells, haematopoietic stem cells and immune cells, engage in a dialogue with tumour cells. Some of these cells modify tumour biology, while others are disrupted and out-competed by tumour cells, thus leading to distinct phases of tumour cell migration, dormancy and latency, and therapy resistance and progression to overt bone metastases. Several current bone-protective therapies act by interrupting these interactions, mainly by targeting tumour cell-osteoclast interactions. In this Review, we describe the functional roles of the bone microenvironment and its components in the initiation and propagation of skeletal metastases, outline the biology and clinical relevance of CTCs and DTCs, and discuss established and future therapeutic approaches that specifically target defined components of the bone microenvironment to prevent or treat skeletal metastases.

AB - Bone metastases are a frequent and severe complication of advanced-stage cancers. Breast and prostate cancers, the most common malignancies in women and men, respectively, have a particularly high propensity to metastasize to bone. Conceptually, circulating tumour cells (CTCs) in the bloodstream and disseminated tumour cells (DTCs) in the bone marrow provide a snapshot of the dissemination and colonization process en route to clinically apparent bone metastases. Many cell types that constitute the bone microenvironment, including osteoblasts, osteocytes, osteoclasts, adipocytes, endothelial cells, haematopoietic stem cells and immune cells, engage in a dialogue with tumour cells. Some of these cells modify tumour biology, while others are disrupted and out-competed by tumour cells, thus leading to distinct phases of tumour cell migration, dormancy and latency, and therapy resistance and progression to overt bone metastases. Several current bone-protective therapies act by interrupting these interactions, mainly by targeting tumour cell-osteoclast interactions. In this Review, we describe the functional roles of the bone microenvironment and its components in the initiation and propagation of skeletal metastases, outline the biology and clinical relevance of CTCs and DTCs, and discuss established and future therapeutic approaches that specifically target defined components of the bone microenvironment to prevent or treat skeletal metastases.

KW - Animals

KW - Bone Neoplasms/pathology

KW - Humans

KW - Molecular Targeted Therapy/methods

KW - Neoplasm Metastasis

KW - Neoplastic Cells, Circulating/pathology

KW - Therapies, Investigational/methods

KW - Tumor Microenvironment/drug effects

U2 - 10.1038/s41571-021-00499-9

DO - 10.1038/s41571-021-00499-9

M3 - SCORING: Review article

C2 - 33875860

VL - 18

SP - 488

EP - 505

JO - NAT REV CLIN ONCOL

JF - NAT REV CLIN ONCOL

SN - 1759-4774

IS - 8

ER -