Denosumab: Delay of bone metastasis in men with nonmetastatic

In a large multicenter phase 3 randomized controlled
trial published in Lancet, Smith and colleagues highlight
a potential new indication for denosumab for patients
with hormone refractory prostate cancer (1). Already
approved for prevention of skeletal-related events in the
setting of bone metastases in solid tumors (Xgeva) and
prevention of androgen deprivation therapy (ADT) induced
bone loss (Prolia), the authors theorized that denosumab
administered prior to bone metastasis might stabilize the
bone microenvironment thus delaying time to first bone
metastasis. Men with castrate-resistant nonmetastatic
prostate cancer treated with denosumab showed improved
bone-metastasis-free survival and delayed time to first bone
metastasis compared to those dosed with placebo.