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Emerging cancer drugs may drive bone tumors
Date:2/13/2013

fic to bone, Novack and her colleagues tested long-established drugs called bisphosphonates that inhibit osteoclasts and are used to treat osteoporosis.

"We found that bisphosphonate treatment protected bone from the negative effects of these drugs," Novack says. "While bisphosphonates are common for breast cancer patients, they're not, for example, commonly given to lung cancer patients. But since IAP antagonists are now in lung cancer trials, we're saying doctors may want to consider bisphosphonate treatment for lung cancer or other cancer patients receiving these drugs. Or at least closely monitor the bone status."

IAP antagonists are now only available to patients enrolled in phase 1 or 2 clinical trials. While these kinds of trials examine the short-term safety and effectiveness of new drugs, the researchers say they may not catch bone metastasis.

"These trials do not necessarily look for long-term effects of the drugs," says Chang Yang, MD, PhD, staff scientist and the paper's first author. "If the cancer is going to metastasize to bone, it may take six months to two years to see that outcome. This may not be seen during the clinical trial."

Numerous drug companies are developing IAP antagonists intended for many kinds of cancer, but only Genentech agreed to provide Novack and her colleagues with its drug, called BV6, to evaluate in the study. Because the investigators could not obtain other proprietary IAP antagonists, they also made two other similar drug compounds and found them to have the same detrimental effects on the bone.

And to further ensure that over-stimulated osteoclasts are the only culprit in the bone metastasis associated with these new drugs, they performed studies in mice that lack the ability to dial up the production of osteoclasts. Even when given IAP antagonists, these mice were protected from osteoporosis and osteoclast activation.

Together, Novack says the studies have demonstrated
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Contact: Julia Evangelou Strait
straitj@wustl.edu
314-286-0141
Washington University School of Medicine
Source:Eurekalert  

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