Bone metastasis of cancer
Osteolytic bone metastases are frequent in patients with advanced cancer of the breast, lung, and (to a lesser extent) the prostate. Roentgenography, bone scintigraphy, and bone biopsies are commonly used for the early identification and follow-up of these conditions. These methods have though marked shortcomings as they are all static methods giving a picture of the current situation in bone but not telling about rate of changes taking place in bone. Metabolic bone markers have been shown to be a useful tool for monitoring metastatic bone activity.
It has been shown that there are two different pathways of bone resorption: the cathepsin K-mediated pathway, which is active during physiological resorption of bone, and the matrix metalloproteinase pathway, which functions mainly in pathological situations. ICTP specifically reflects matrix metalloproteinase-mediated pathological degradation of bone collagen (1, 2). ICTP is thus a highly specific marker of bone degradation in bone metastasis and constitutes a sensitive and easy means of detecting bone metastases of cancer (3-5) and monitoring the response to treatment (6).
1. Garnero P et al. The type I collagen fragments ICTP and CTX reveal distinct enzymatic pathways of bone collagen degradation. J Bone Miner Res 2003;18:859-867. 2. Sassi ML et al. Immunochemical characterisation of assay for carboxyterminal telopeptide of human type I collagen: Loss of antigenicity by treatment with cathepsin K. Bone 2000;26:367-373. 3. Leeming D et al. The relative use of eight collagenous and noncollagenous markers for diagnosis of skeletal metastases in breast, prostate, or lung cancer patients. Cancer Epidemiol Biomarkers Prev 2006;15:32-38. 4. Santala M et al. Comparison of carboxyterminal telopeptide of type I collagen (ICTP) and CA 125 as predictors of prognosis in ovarian cancer. Anticanc Res 2004;24:1057-1062. 5. Voorzanger-Rousselot N et al. Association of 12 serum biochemical markers of angiogenesis, tumour invasion and bone turnover with bone metastases from breast cancer: a crossectional and longitudinal evaluation. Br J Cancer 2006;95:506-514. 6. Lein M et al. Serial markers of bone turnover in men with metastatic prostate cancer treated with zoledronic Acid for detection of bone metastases progression. Eur Urol 2007;52:1381-7.
Published January 4, 2017