Role of Body Composition in the Prediction of Skeletal Fragility Induced by Hormone Deprivation Therapies in Cancer Patients

Overview

Journal Curr Oncol Rep

Publisher Current Science

Specialty Oncology

Date 2023 Aug 25

PMID 37624550

Authors

Alberto Dalla Volta

Irene Caramella

Pierluigi di Mauro

Marco Bergamini

Deborah Cosentini

Francesca Valcamonico

Carlo Cappelli

Marta Lagana

Nunzia di Meo

Davide Farina

Rebecca Pedersini

Gherardo Mazziotti

Alfredo Berruti

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: This review paper is intended to show that changes in body composition are key in the pathogenesis of bone fragility amongst patients with breast and prostate cancer receiving hormone deprivation therapies (HDTs) and that the mechanism is based on the development of alterations in bone quality rather than in bone quantity.

Recent Findings: Preclinical and clinical data suggest a tight connection amongst bone, adipose and muscular tissues by means of several soluble mediators, potentially leading to (1) bone resorption and bone quality deterioration in sarcopenic obese subjects, (2) bone mineral deposition in healthy trained subjects. Cancer patients treated with HDTs frequently fall into the first condition, named osteosarcopenic obesity. Current clinical guidelines for the prevention of treatment-induced osteoporosis focus on bone mineral density (BMD) as a main predictive factor for fracture risk; however, the pathophysiology underlying HDT-induced bone fragility differs from that of primary and postmenopausal osteoporosis, suggesting a prevalent role for bone quality alterations. Focusing on available data from clinical trials, in our review we suggest osteosarcopenic obesity as a common target for the prevention and treatment of HDTs-related metabolic and skeletal complications, beyond a BMD-centred approach.

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References

Irwin M, Alvarez-Reeves M, Cadmus L, Mierzejewski E, Mayne S, Yu H . Exercise improves body fat, lean mass, and bone mass in breast cancer survivors. Obesity (Silver Spring). 2009; 17(8):1534-41. PMC: 2841468. DOI: 10.1038/oby.2009.18. View

Saito T, Ono R, Kono S, Asano M, Fukuta A, Tanaka Y . Physical activity among patients with breast cancer receiving aromatase inhibitors is associated with bone health: a cross-sectional observational study. Breast Cancer Res Treat. 2020; 182(1):187-193. DOI: 10.1007/s10549-020-05668-5. View

Yang J, Ye H, Zhu Q, Zhang J, Liu Q, Xie H . Effects of resistance training on body composition and physical function in elderly patients with osteosarcopenic obesity: a systematic review and meta-analysis. Arch Osteoporos. 2022; 17(1):82. PMC: 9163017. DOI: 10.1007/s11657-022-01120-x. View

Woods G, Ewing S, Schafer A, Gudnason V, Sigurdsson S, Lang T . Saturated and Unsaturated Bone Marrow Lipids Have Distinct Effects on Bone Density and Fracture Risk in Older Adults. J Bone Miner Res. 2022; 37(4):700-710. PMC: 9018474. DOI: 10.1002/jbmr.4504. View

Weber D, Long J, Leonard M, Zemel B, Baker J . Development of Novel Methods to Define Deficits in Appendicular Lean Mass Relative to Fat Mass. PLoS One. 2016; 11(10):e0164385. PMC: 5056731. DOI: 10.1371/journal.pone.0164385. View

Lynch G, Murphy C, de Marco Castro E, Roche H . Inflammation and metabolism: the role of adiposity in sarcopenic obesity. Proc Nutr Soc. 2020; :1-13. DOI: 10.1017/S0029665120007119. View

Pedersini R, Cosentini D, Rinaudo L, Zamparini M, Ulivieri F, di Mauro P . Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study. Bone Rep. 2023; 18:101654. PMC: 9868326. DOI: 10.1016/j.bonr.2023.101654. View

Wilhelmsen A, Tsintzas K, Jones S . Recent advances and future avenues in understanding the role of adipose tissue cross talk in mediating skeletal muscle mass and function with ageing. Geroscience. 2021; 43(1):85-110. PMC: 8050140. DOI: 10.1007/s11357-021-00322-4. View

Berendsen A, Olsen B . Osteoblast-adipocyte lineage plasticity in tissue development, maintenance and pathology. Cell Mol Life Sci. 2013; 71(3):493-7. PMC: 3947173. DOI: 10.1007/s00018-013-1440-z. View

10.

Boskey A, Imbert L . Bone quality changes associated with aging and disease: a review. Ann N Y Acad Sci. 2017; 1410(1):93-106. PMC: 5774017. DOI: 10.1111/nyas.13572. View

11.

Li C, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S . Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J Cachexia Sarcopenia Muscle. 2022; 13(2):781-794. PMC: 8977978. DOI: 10.1002/jcsm.12901. View

12.

Gennari A, Andre F, Barrios C, Cortes J, de Azambuja E, DeMichele A . ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer. Ann Oncol. 2021; 32(12):1475-1495. DOI: 10.1016/j.annonc.2021.09.019. View

13.

Shao W, Zhang H, Qi H, Zhang Y . The effects of exercise on body composition of prostate cancer patients receiving androgen deprivation therapy: An update systematic review and meta-analysis. PLoS One. 2022; 17(2):e0263918. PMC: 8846498. DOI: 10.1371/journal.pone.0263918. View

14.

Tat S, Padrines M, Theoleyre S, Heymann D, Fortun Y . IL-6, RANKL, TNF-alpha/IL-1: interrelations in bone resorption pathophysiology. Cytokine Growth Factor Rev. 2004; 15(1):49-60. DOI: 10.1016/j.cytogfr.2003.10.005. View

15.

Pedersini R, Monteverdi S, Mazziotti G, Amoroso V, Roca E, Maffezzoni F . Morphometric vertebral fractures in breast cancer patients treated with adjuvant aromatase inhibitor therapy: A cross-sectional study. Bone. 2017; 97:147-152. DOI: 10.1016/j.bone.2017.01.013. View

16.

Shockley K, Lazarenko O, Czernik P, Rosen C, Churchill G, Lecka-Czernik B . PPARgamma2 nuclear receptor controls multiple regulatory pathways of osteoblast differentiation from marrow mesenchymal stem cells. J Cell Biochem. 2008; 106(2):232-46. PMC: 2745312. DOI: 10.1002/jcb.21994. View

17.

Cianferotti L, Brandi M . Muscle-bone interactions: basic and clinical aspects. Endocrine. 2013; 45(2):165-77. DOI: 10.1007/s12020-013-0026-8. View

18.

Vena W, Pizzocaro A, Indirli R, Amer M, Maffezzoni F, Delbarba A . Prevalence and determinants of radiological vertebral fractures in patients with Klinefelter syndrome. Andrology. 2020; 8(6):1699-1704. DOI: 10.1111/andr.12841. View

19.

Compston J, Flahive J, Hosmer D, Watts N, Siris E, Silverman S . Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). J Bone Miner Res. 2013; 29(2):487-93. PMC: 4878680. DOI: 10.1002/jbmr.2051. View

20.

Ilich J, Kelly O, Inglis J, Panton L, Duque G, Ormsbee M . Interrelationship among muscle, fat, and bone: connecting the dots on cellular, hormonal, and whole body levels. Ageing Res Rev. 2014; 15:51-60. DOI: 10.1016/j.arr.2014.02.007. View