Bisphosphonates, Denosumab, and Anabolic Agents in the Treatment of Metastatic Bone Disease

Cancer uses local factors to activate the ever-present osteoclasts in bone to prepare a cavity into which it may grow. For this reason, medical treatments have targeted the recruitment of osteoclasts to decrease metastasis. At the moment, two major classes of drugs are utilized for this purpose: the bisphosphonates and denosumab. This chapter summarizes the mechanisms of action and modes of use in metastatic bone treatment of these drugs, along with their side effects and how these may be addressed.