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Imaging for Plasma Cell Dyscrasias: What, When, and How?

Imaging plays a vital role in the diagnosis, response assessment, and follow-up of patients with plasma cell bone disease. The radiologic diagnostic paradigm has thus far evolved with developing technology and availability of better imaging platforms; however, the skewed availability of these imaging modalities in developed vis-à-vis the developing countries along with the lack of uniformity in reporting has led to a consensus on the imaging criteria for diagnosing and response assessment in plasma cell dyscrasia. Therefore, it is imperative for not only the radiologists but also the treating

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… The steps in the molecular pathogenesis that serve as modulatory checkpoints for therapeutic agents have been numbered from 1 to 4 and represent targets for the following pharmacologic agents: 1—anti-neoplastic drugs (chemotherapeutic agents); 2—RANK ligand inhibitors, such as denosumab; 3—osteoclast …

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Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis.

INTRODUCTION: This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in patients with cancer and compromised bone health. MATERIALS AND METHODS: A comprehensive search of four electronic databases was conducted to identify randomized controlled trials evaluating the effect of exercise intervention compared to supplementation or bone-targeted agents only on BMD, BMC and bone turnover markers. Meta-analyses were performed using random-effects models to calculate effect

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… Borsati A et al (2025) Combining a 9-month tailored physical exercise program with osimertinib and denosumab in a patient affected by advanced NSCLC with multiple osteolytic bone lesions: a case report. Heliyon 11(4):e42768 45. …

Perspectives on the Treatment of Multiple Myeloma.

The treatment of multiple myeloma has evolved significantly over the past few decades with the development of novel therapeutics. The introduction of proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, and high-dose chemotherapy followed by hematopoietic stem cell transplantation has led to improved response rates and survival outcomes. The use of bispecific antibodies and chimeric antigen receptor T-cell therapy is currently under study, and early results are showing promise. Although outcomes for patients with MM have improved with the development of new treatments, there r

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… While bisphosphonates and denosumab have been shown to reduce skeletal-related events, they are not curative and do not restore bone integrity. Novel therapies that target bone remodeling and promote bone healing are needed to address this unmet need. …

Hotspots and trends in multiple myeloma bone diseases: A bibliometric visualization analysis.

Objective: This study aims to explore the research hotspots and trends of multiple myeloma bone disease in the past 20 years by bibliometric visualization analysis. Methods: With the Web of Science Core Collection database as the data source, the relevant publications of multiple myeloma bone disease from 2002 to 2021 are retrieved. These data are analyzed using software CiteSpace 5.8.R3 and Scimago Graphica 1.0.24, together with the Online Analysis Platform of Literature Metrology. Results: A total of 6,168 published research papers, including 4668 articles and 1500 review papers, are include

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… It can find from the figure that # 3 clonal evolution, # 8 denosumab, # 12 immunotherapy, # 13 PET/CT, # 14 minimal residual disease are research hotspots in recent years. References with citation burstness Citation burstness refers to citation surge of some paper in a short period of time. …

Genetic Therapy and Molecular Targeted Therapy in Oncology: Safety, Pharmacovigilance, and Perspectives for Research and Clinical Practice.

The impressive advances in the knowledge of biomarkers and molecular targets has enabled significant progress in drug therapy for crucial diseases such as cancer. Specific areas of pharmacology have contributed to these therapeutic outcomes-mainly targeted therapy, immunomodulatory therapy, and gene therapy. This review focuses on the pharmacological profiles of these therapeutic classes and intends, on the one hand, to provide a systematic definition and, on the other, to highlight some aspects related to pharmacovigilance, namely the monitoring of safety and the identification of potential t

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… cancer in patients who previously received trastuzumab or a taxan Fully human (-umab) | | Avelumab | PD-L1 | Merkel-cell carcinoma (MCC), ulcerative colitis (UC), renal cell carcinoma (RCC) Cemiplimab-rwlc | PD-1 | Cutaneous squamous cell carcinoma (CSCC) Daratumumab | CD38 | Multiple myeloma (MM) Denosumab …

Mesenchymal stem cell-derived interleukin-28 drives the selection of apoptosis resistant bone metastatic prostate cancer.

Bone metastatic prostate cancer (PCa) promotes mesenchymal stem cell (MSC) recruitment and their differentiation into osteoblasts. However, the effects of bone-marrow derived MSCs on PCa cells are less explored. Here, we report MSC-derived interleukin-28 (IL-28) triggers prostate cancer cell apoptosis via IL-28 receptor alpha (IL-28Rα)-STAT1 signaling. However, chronic exposure to MSCs drives the selection of prostate cancer cells that are resistant to IL-28-induced apoptosis and therapeutics such as docetaxel. Further, MSC-selected/IL-28-resistant prostate cancer cells grow at accelerated rat

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… Understanding how osteoblasts and osteoclasts mediate these effects has led to the development of therapies that target the microenvironment, such as the RANKL binding monoclonal antibody denosumab and nitrogen containing bisphosphonates that block osteoclast formation and activity 3 . …

Management of patients with multiple myeloma beyond the clinical-trial setting: understanding the balance between efficacy, safety and tolerability, and quality of life.

Treatment options in multiple myeloma (MM) are increasing with the introduction of complex multi-novel-agent-based regimens investigated in randomized clinical trials. However, application in the real-world setting, including feasibility of and adherence to these regimens, may be limited due to varying patient-, treatment-, and disease-related factors. Furthermore, approximately 40% of real-world MM patients do not meet the criteria for phase 3 studies on which approvals are based, resulting in a lack of representative phase 3 data for these patients. Therefore, treatment decisions must be tai

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… Symptoms related to the CRAB criteria (hypercalcemia, renal impairment, anemia, and bone disease) can be debilitating and may require supportive therapy such as bisphosphonates or denosumab 18 . …

Diagnosis and Treatment of Bone Metastases in Breast Cancer: Radiotherapy, Local Approach and Systemic Therapy in a Guide for Clinicians.

The standard care for metastatic breast cancer (MBC) is systemic therapies with imbrication of focal treatment for symptoms. Recently, thanks to implementation of radiological and metabolic exams and development of new target therapies, oligometastatic and oligoprogressive settings are even more common-paving the way to a paradigm change of focal treatments role. In fact, according to immunophenotype, radiotherapy can be considered with radical intent in these settings of patients. The aim of this literature review is to analyze available clinical data on prognosis of bone metastases from brea

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… Bisphosphonates and denosumab are commonly used in clinical practice and their therapeutic effect is based on targeting locoregional tissue cells to activate not only blocking of resorption mechanism, but also activating antitumor response by immune system activation. Radiopharmaceuticals. …

Nucleic acid aptamers in orthopedic diseases: promising therapeutic agents for bone disorders.

Precision medicine has become a cornerstone in modern therapeutic strategies, with nucleic acid aptamers emerging as pivotal tools due to their unique properties. These oligonucleotide fragments, selected through the Systematic Evolution of Ligands by Exponential Enrichment process, exhibit high affinity and specificity toward their targets, such as DNA, RNA, proteins, and other biomolecules. Nucleic acid aptamers offer significant advantages over traditional therapeutic agents, including superior biological stability, minimal immunogenicity, and the capacity for universal chemical modificatio

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… with no gender, racial, or ethnic predilection. 488 , 492 , 493 The primary treatment goals for OI are to prevent fractures, manage symptoms, and increase bone mass; however, currently available therapeutic options have limited efficacy. 494 , 495 Commonly used medications, such as bisphosphonates, denosumab …

Gaucher Disease in Bone: From Pathophysiology to Practice.

Gaucher disease (GD) is a rare, genetic lysosomal disorder leading to lipid accumulation and dysfunction in multiple organs. Involvement of the skeleton is one of the most prevalent aspects of GD and a major cause of pain, disability, and reduced quality of life. Uniform recommendations for contemporary evaluation and management are needed. To develop practical clinical recommendations, an international group of experienced physicians conducted a comprehensive review of 20 years' of the literature, defining terms according to pathophysiological understanding and pointing out best practice and

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… The effects and recommended administration of new bone agents (eg, denosumab) have not been established in GD. …

A Systematic Review of the Effects of Bisphosphonates on Osteoblasts In Vitro.

Bisphosphonates (BPs) are widely used to treat bone disorders, prevent skeletal-related events, and manage bone metastasis. These drugs are synthetic analogs of pyrophosphate and primarily function by inhibiting osteoclast activity. However, increasing evidence suggests that they also have an effect on osteoblasts. This systematic review aims to evaluate how bisphosphonates affect osteoblasts by summarizing findings from in vitro studies on the impact of BPs on osteoblast lineage cells, addressing the following question: "Do bisphosphonates affect osteoblast cell lineage function?". For this p

Consensus Statement on Full-Arch Implant Rehabilitations: Evidence-Based Recommendations from the Italian Consensus Conference.

Full-arch implant-supported rehabilitations are widely recognized as an effective treatment option for edentulous patients. Nevertheless, clinical decision-making regarding patient selection, surgical planning, prosthetic material choice, and long-term maintenance protocols remains heterogeneous and requires structured evidence-based guidance. A modified Delphi consensus process was conducted involving 29 experts during the Italian Consensus Conference. A systematic literature review covering the period 2015-2024 was performed, and the certainty of evidence was assessed using the Grading of Re

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… Four categories of patients at increased MRONJ risk are recognised: patients with bone metastases or multiple myeloma receiving HD-BMA therapy; patients with breast or prostate cancer receiving LD-BMA therapy for cancer-treatment-induced bone loss (CTIBL); patients receiving denosumab for giant cell …

Cuproptosis related genes in immune infiltration and treatment of osteoporosis by bioinformatic analysis and machine learning methods.

Cuproptosis, a copper-dependent form of cell death, has been implicated in immune function and osteoporosis. However, the specific roles of cuproptosis-related genes (CRGs) in osteoporosis remain unclear. The differentially expressed CRGs from the Gene Expression Omnibus datasets of persons with osteoporosis and healthy individuals were categorized using R software tools in this study. Following that, the CIBERSORT algorithm and the GSVA technique were used to investigate the relationships between the different clusters and immune infiltration characteristics. Based on four machine learning te

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… Interventions for prevention and treatment include hormone replacement therapy, bisphosphonates, Denosumab, Raloxifene, Parathyriod homone peptides, Romosozumab, calcium and vitamin D, herbs and exercise ( Liu et al., 2017 ; Stevenson and medical advisory council of the British Menopause, 2023 ). …

Effects of exosomes from different origins on osteoclasts.

Abnormal osteoclast function is closely related to the development of osteolytic diseases such as osteoporosis and tumor bone metastasis, which seriously affects patients' quality of life. The cellular microenvironment is complex and variable, and exosomes, as an important pathway mediating intercellular communication, can be secreted by a variety of cells in the human body, which carry "cargo" that can affect the biological function of recipient cells. Osteoclasts receive a variety of cellular exosomes to regulate and influence the body's bone homeostasis. In this narrative review, we summari

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… Combination denosumab and high dose teriparatide for postmenopausal osteoporosis (DATA-HD): a randomised, controlled phase 4 trial. Lancet Diabetes Endocrinol. 2019;7:767–75. 5. Wang Z, Zhao Z, Gao B, Zhang L. Exosome mediated biological functions within skeletal microenvironment. …

Lenalidomide, bortezomib and dexamethasone induction therapy for the treatment of newly diagnosed multiple myeloma: a practical review.

For patients with newly diagnosed multiple myeloma, survival outcomes continue to improve significantly: however, nearly all patients will relapse following induction treatment. Optimisation of induction therapy is essential to provide longer term disease control and the current standard of care for most patients incorporates an immunomodulatory agent and proteasome inhibitor, most commonly lenalidomide and bortezomib in combination with dexamethasone (RVD), with maintenance until progression. Historically there has been limited access to RVD as an induction strategy outside of the United Stat

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… Denosumab might be considered over zoledronic acid in patients with renal dysfunction or refractory hypercalcaemia. 64 Intravenous immunoglobulin (400 mg/kg every 4 weeks) may be considered in patients with recurrent bacterial infections and documented hypogammaglobulinaemia. 54 As a final remark, MM …

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review.

Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Th

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… Although we have a lot of groups of drugs such as antibiotics, bisphosphonates, anabolic drugs (parathyroid hormone, anti-sclerostin antibodies), estrogen, denosumab and selective estrogen receptor modulators, only a few of them have been used for implant coating. …

Hematopoietic Niche Hijacking in Bone Metastases: Roles of Megakaryocytes, Erythroid Lineage Cells, and Perivascular Stromal Subsets.

Bone metastases mark a critical and often terminal phase in cancer progression, where disseminated tumor cells (DTCs) manage to infiltrate and exploit the complex microenvironments of the bone marrow. While most current therapies focus on the well-known late-stage "vicious cycle" of osteolysis, they often overlook the earlier stages, namely, tumor cell colonization and dormancy. During these early phases, cancer cells co-opt hematopoietic stem cell (HSC) niches, using them as sanctuaries for long-term survival. In this review, we bring together emerging insights that highlight a trio of undera

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… Current comprehensive understanding of denosumab (the RANKL neutralizing antibody) in the treatment of bone metastasis of malignant tumors, including pharmacological mechanism and clinical trials Front. Oncol. 2023 13 1133828 10.3389/fonc.2023.1133828 36860316 PMC9969102 122. Steggerda S.M. …

EZH2 serves as a viable therapeutic target for myeloma-induced osteolytic bone destruction.

Myelomatous bone disease is a complication characterized by lytic bone lesions, reduced bone formation, bone pain, and increased fracture risk. Understanding these underlying mechanisms is crucial for developing effective therapeutic approaches. Here we show the role of enhancer of zeste homolog 2 (EZH2) in bone lesions induced by myeloma cells. Our research reveals that cytokines produced by myeloma-associated adipocytes activate the expression of EZH2 in myeloma cells. Furthermore, we find that EZH2 forms a transcriptional repression complex with transcription factor AP2α. This complex promo

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… Additionally, the anti-bone resorption drug denosumab (RANKL monoclonal antibody) has been approved for market use, but its phase III clinical trial results only demonstrated moderate anti-bone resorption activity and it does not aid in restoring osteoblast activity 37 . …

Race for the Cure: From the Oldest to the Newest Monoclonal Antibodies for Multiple Myeloma Treatment.

Multiple myeloma is characterized by a wide clinical heterogeneity due to an intricate network of interactions between bone marrow-resident clonal plasma cells and the microenvironment. Over the last years, dramatic improvement in the understanding of these pathways led to the introduction of novel drugs with immune-mediated mechanisms of action. Some of these compounds, such as the anti-cd38 daratumumab and isatuximab, the anti-slamf-7 elotuzumab, and the antibody-drug conjugate belantamab-mafodotin, have been tested in large clinical trials and have now fully entered the real-life management

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… Denosumab: it is an inhibitor of RANK-L, which plays a leading role in the survival of osteoclasts. It might be of interest in the treatment of MM since it seems to slow progression through suppression of tumor escape in patients already on supportive treatment with this drug [ 97 ]. …