Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials
Abstract Purpose Metastatic spread of prostate cancer to the skeleton may result in debilitating bone pain. In this review, we address mechanisms underpinning the pathobiology of metastatic prostate cancer induced bone pain (PCIBP) that include sensitization and sprouting of primary afferent sensory...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Springer
2022-10-01
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| Series: | Discover Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s12672-022-00569-z |
| _version_ | 1798030841753894912 |
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| author | A. E. Smith A. Muralidharan M. T. Smith |
| author_facet | A. E. Smith A. Muralidharan M. T. Smith |
| author_sort | A. E. Smith |
| collection | DOAJ |
| description | Abstract Purpose Metastatic spread of prostate cancer to the skeleton may result in debilitating bone pain. In this review, we address mechanisms underpinning the pathobiology of metastatic prostate cancer induced bone pain (PCIBP) that include sensitization and sprouting of primary afferent sensory nerve fibres in bone. We also review current treatments and pain responses evoked by various treatment modalities in clinical trials in this patient population. Methods We reviewed the literature using PubMed to identify research on the pathobiology of PCIBP. Additionally, we reviewed clinical trials of various treatment modalities in patients with PCIBP with pain response outcomes published in the past 7 years. Results Recent clinical trials show that radionuclides, given either alone or in combination with chemotherapy, evoked favourable pain responses in many patients and a single fraction of local external beam radiation therapy was as effective as multiple fractions. However, treatment with chemotherapy, small molecule inhibitors and/or immunotherapy agents, produced variable pain responses but pain response was the primary endpoint in only one of these trials. Additionally, there were no published trials of potentially novel analgesic agents in patients with PCIBP. Conclusion There is a knowledge gap for clinical trials of chemotherapy, small molecule inhibitors and/or immunotherapy in patients with PCIBP where pain response is the primary endpoint. Also, there are no novel analgesic agents on the horizon for the relief of PCIBP and this is an area of large unmet medical need that warrants concerted research attention. |
| first_indexed | 2024-04-11T19:47:50Z |
| format | Article |
| id | doaj.art-19f1f600843041ae916017cf971aab3e |
| institution | Directory Open Access Journal |
| issn | 2730-6011 |
| language | English |
| last_indexed | 2024-04-11T19:47:50Z |
| publishDate | 2022-10-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj.art-19f1f600843041ae916017cf971aab3e2022-12-22T04:06:24ZengSpringerDiscover Oncology2730-60112022-10-0113112310.1007/s12672-022-00569-zProstate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trialsA. E. Smith0A. Muralidharan1M. T. Smith2St Vincent’s HospitalNeurobiology of Chronic Pain, The Charles Perkins Centre, Faculty of Science, The University of SydneyCentre for Integrated Preclinical Drug Development, School of Biomedical Sciences, Faculty of Medicine, The University of QueenslandAbstract Purpose Metastatic spread of prostate cancer to the skeleton may result in debilitating bone pain. In this review, we address mechanisms underpinning the pathobiology of metastatic prostate cancer induced bone pain (PCIBP) that include sensitization and sprouting of primary afferent sensory nerve fibres in bone. We also review current treatments and pain responses evoked by various treatment modalities in clinical trials in this patient population. Methods We reviewed the literature using PubMed to identify research on the pathobiology of PCIBP. Additionally, we reviewed clinical trials of various treatment modalities in patients with PCIBP with pain response outcomes published in the past 7 years. Results Recent clinical trials show that radionuclides, given either alone or in combination with chemotherapy, evoked favourable pain responses in many patients and a single fraction of local external beam radiation therapy was as effective as multiple fractions. However, treatment with chemotherapy, small molecule inhibitors and/or immunotherapy agents, produced variable pain responses but pain response was the primary endpoint in only one of these trials. Additionally, there were no published trials of potentially novel analgesic agents in patients with PCIBP. Conclusion There is a knowledge gap for clinical trials of chemotherapy, small molecule inhibitors and/or immunotherapy in patients with PCIBP where pain response is the primary endpoint. Also, there are no novel analgesic agents on the horizon for the relief of PCIBP and this is an area of large unmet medical need that warrants concerted research attention.https://doi.org/10.1007/s12672-022-00569-zProstate cancer induced bone pain (PCIBP)Metastatic castrate-resistant prostate cancer (mCRPC)AnalgesicsNSAIDsOpioidsMorphine |
| spellingShingle | A. E. Smith A. Muralidharan M. T. Smith Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials Discover Oncology Prostate cancer induced bone pain (PCIBP) Metastatic castrate-resistant prostate cancer (mCRPC) Analgesics NSAIDs Opioids Morphine |
| title | Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials |
| title_full | Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials |
| title_fullStr | Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials |
| title_full_unstemmed | Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials |
| title_short | Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials |
| title_sort | prostate cancer induced bone pain pathobiology current treatments and pain responses from recent clinical trials |
| topic | Prostate cancer induced bone pain (PCIBP) Metastatic castrate-resistant prostate cancer (mCRPC) Analgesics NSAIDs Opioids Morphine |
| url | https://doi.org/10.1007/s12672-022-00569-z |
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