Efficacy of innovative systemic treatments in combination with radiotherapy for bone metastases: a GEMO (the European Study Group of Bone Metastases) state of the art.

Date publication

janvier 2025

Journal

Cancer metastasis reviews

Auteurs

Membres identifiés du Cancéropôle Est :
Dr FAIVRE Jean-Christophe

Tous les auteurs :
Gueiderikh A, Faivre JC, Golfier C, Escande A, Thureau S

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/39875680

Résumé

The management of bone metastases (BoM) requires a multidisciplinary approach to prevent complications, necessitating updated knowledge in light of the rapid advancements in systemic treatments and surgical, interventional radiology or radiation techniques. This review aims to discuss efficacy of new systemic treatments on BoM, the benefits of radiotherapy adjunction, and the optimal methods for combining them. Preliminary evidence suggesting reduced efficacy of immune checkpoint inhibitors (ICI), and several multi-kinase inhibitors regarding BoM may encourage early use of radiotherapy (RT). Systemic treatment efficacy modulation by RT and ablative RT strategies are explored. Concerns for increased side effects for several kinase inhibitors and double ICI in combination with RT imply suspending those systemic treatments during RT. Various timing strategies to combine prostate hormone therapies and RT are developed. Emerging internal vectorized radiotherapy molecules necessitate developing new combination strategies with RT. Further prospective data collection and comparative trials should be encouraged.

Mots clés

Androgen deprivation therapy, EGFR inhibitors, Immune checkpoint inhibitors, Lutetium-PSMA, New generation hormonal treatments, Radiotherapy, SBRT, Tyrosine kinase inhibitors

Référence

Cancer Metastasis Rev. 2025 01 29;44(1):28