Review article
https://doi.org/10.3325/cmj.2021.62.270
The pathogenesis of bone metastasis in solid tumors: a review
Ivan Vičić
orcid.org/0000-0002-7411-2123
Borislav Belev
; University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
Owing to its frequent occurrence and severe clinical picture, bone metastasis is an important problem in the clinical course of tumor diseases. Bone metastasis develops
when the physiological remodeling process is disrupted
by tumor cells via the same molecular mechanisms used
by native bone cells. The process includes molecular crosstalk between osteocytes and osteoblasts and osteoclasts.
Osteolytic bone metastasis, most often seen in breast cancer, is characterized by promoted differentiation and function of osteoclasts and reduced osteoblast function. Tumor
cells take advantage of factors released by bone tissue resorption, thus establishing a vicious cycle that promotes
the metastatic process. In osteoblastic metastasis, most often seen in prostate cancer, osteoblast function and differentiation are promoted, while osteoclast activity is reduced, resulting in net gain of bone tissue. Mechanisms
involved in the early stages of bone metastasis and cancer
cell dormancy have been understudied, and their exploration may pave the way for potential therapeutic strategies. Tumor affects the bone marrow microenvironment
via exosomes, soluble factors, and membrane-bound ligands. In this way, an initial lesion is established, which after
a variable duration of disseminated tumor cells dormancy
progresses to an overt condition. The current review deals
with basic mechanisms involved in bone metastasis formation and propagation. We illustrated a disparity between
the diversity and number of factors included in the disease
pathophysiology and the number of available and developing therapeutic options. We also examined new therapeutic strategies affecting molecular pathways.
Keywords
Hrčak ID:
278137
URI
Publication date:
24.6.2021.
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