Pharmacological management of prostate cancer-bone metastasis and recent advancements: A comprehensive review

Objective This review discusses current strategies, new advancements and clinical trials for the treatment of bone metastases. Method We performed a narrative review using literatures obtained from PubMed and Google Scholar using the terms such as “Prostate cancer”, “bone metastases”, “treatment”. The search included articles between 2000 and 2024. For clinical trial information, we searched www.clincialtrial.gov and included trials of Prostate cancer and bone metastases. Summary We go through the mechanisms of action, clinical effectiveness, and limitations of current and emerging therapies, including bisphosphonates, Receptor activator of nuclear factor kappa-Β ligand (RANKL) inhibitors, novel agents and Prostate-Specific Membrane Antigen (PSMA) targeted approaches. By examining recent research and ongoing clinical trials, we seek to inform the development of optimized treatment strategies and guide future research directions. The review discuss about novel agents such as Radium-223 and Lutetium-177. Lutetium-177 is emerging as a promising treatment for metastatic prostate cancer with bone involvement. These treatment options offer significant survival benefits in patients with bone-dominant metastatic prostate cancer. The review also explores combination treatments, where integrating bone-targeted therapies with systemic prostate cancer treatments holding potential for enhanced efficacy. Ongoing clinical trials investigating novel treatment options and advanced drug delivery techniques are highlighted. Conclusion The advancements signify a promising direction in the treatment of bone metastases in prostate cancer, highlighting the need for continuous innovation to enhance patient care and outcomes