This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fohr, B. Articles by Seibel, M. J. Search for Related Content PubMed PubMed Citation Articles by Fohr, B. Articles by Seibel, M. J.

Markers of Bone Remodeling in Metastatic Bone Disease

Department of Medicine (B.F.), University of Heidelberg, D-69117 Heidelberg, Germany; and Bone Research Program, ANZAC Research Institute, and Department of Endocrinology, Concord Hospital Medical Centre (C.R.D., M.J.S.), University of Sydney, Sydney 2139, New South Wales, Australia

Address all correspondence and requests for reprints to: Prof. Markus J. Seibel, M.D., Ph.D., F.R.A.C.P., Bone Research Program, ANZAC Research Institute, and Department of Endocrinology and Metabolism, Concord Hospital Medical Centre, The University of Sydney, Sydney, New South Wales 2139, Australia. E-mail: mjs{at}anzac.edu.au.

Many cancers have a strong propensity to spread to bone. The processes involved in cancer dissemination to bone are complex and variable, and the changes in bone metabolism, once bony metastases have occurred, are usually profound. This review surveys the usefulness of bone markers in the diagnosis and follow-up of patients with malignant bone disease.

In patients with established bone metastases, most markers of bone remodeling are abnormal compared with healthy controls or cancer patients without bone lesions. Although bone markers may have a potential as diagnostic tools in cancer patients, the available data do not allow final conclusions regarding the accuracy and validity of any of the presently used markers in the diagnosis of bone metastases.

As regards monitoring of anticancer therapy, most markers of bone remodeling respond to active treatments. These indices therefore may have the potential to be used in the monitoring of antitumor therapies. However, most if not all of the available evidence on the use of bone markers in monitoring anticancer therapy is observational, and it remains unclear whether they have any beneficial effects on overall outcome. The same is true for their prognostic value, although evidence suggests that suppressed levels of bone formation or high rates of bone resorption are independent predictors of poor survival.

Abbreviations: ALP, Alkaline phosphatase; BSP, bone sialoprotein; CA, carbohydrate antigen; CT, chemotherapy; CTX-I, C-terminal cross-linked telopeptide of type I collagen; DPD, deoxypyridinoline; GHL, galactosyl-hydroxylysine; ICTP, epitope of C-terminal cross-linked telopeptide of collagen type I; LSC, least significant change; MGUS, monoclonal gammopathy of undetermined significance; MIP1, macrophage inflammatory protein 1; MM, multiple myeloma; NTX-I, N-terminal cross-linked telopeptide of collagen type I; OC, osteocalcin; OHP, hydroxyproline; OPG, osteoprotegerin; PICP, C-terminal propeptide of procollagen type I; PINP, N-terminal propeptide of procollagen type I; PSA, prostate specific antigen; PYD, pyridinoline; RANKL, receptor activator of nuclear factor-B ligand; s, serum; sBALP, serum bone-specific ALP; TRAcP, tartrate-resistant acid phosphatase; u, urinary.

This article has been cited by other articles:

				D. J. Leeming, A. Hegele, I. Byrjalsen, R. Hofmann, P. Qvist, M. A. Karsdal, A. J. Schrader, R. Wagner, and P. Olbert Biochemical Markers for Monitoring Response to Therapy: Evidence for Higher Bone Specificity by a Novel Marker Compared with Routine Markers Cancer Epidemiol. Biomarkers Prev., May 1, 2008; 17(5): 1269 - 1276. [Abstract] [Full Text] [PDF]

				J-J Body, M Lichinitser, S Tjulandin, P Garnero, and B Bergstrom Oral ibandronate is as active as intravenous zoledronic acid for reducing bone turnover markers in women with breast cancer and bone metastases Ann. Onc., July 1, 2007; 18(7): 1165 - 1171. [Abstract] [Full Text] [PDF]

				J. S. Johansen, K. Brasso, P. Iversen, B. Teisner, P. Garnero, P. A. Price, and I. J. Christensen Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival Clin. Cancer Res., June 1, 2007; 13(11): 3244 - 3249. [Abstract] [Full Text] [PDF]

				X.-H. Liu, A. Kirschenbaum, S. Yao, and A. C. Levine Cross-Talk between the Interleukin-6 and Prostaglandin E2 Signaling Systems Results in Enhancement of Osteoclastogenesis through Effects on the Osteoprotegerin/Receptor Activator of Nuclear Factor-{kappa}B (RANK) Ligand/RANK System Endocrinology, April 1, 2005; 146(4): 1991 - 1998. [Abstract] [Full Text] [PDF]

				K. K. Ivaska, T. A. Hentunen, J. Vaaraniemi, H. Ylipahkala, K. Pettersson, and H. K. Vaananen Release of Intact and Fragmented Osteocalcin Molecules from Bone Matrix during Bone Resorption in Vitro J. Biol. Chem., April 30, 2004; 279(18): 18361 - 18369. [Abstract] [Full Text] [PDF]