Bone Metastases and Secondary Osteoporosis

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Background

Bone metastasis is one of the most common complications of malignancies, and axial bone is reported as the most frequent location of metastasis. Bone metastases are closely related to the biological activities of osteoblasts and osteoclasts, which are correlated with imbalanced activation of bone formation and bone resorption. As reported, there are many factors affecting the function of osteoblasts and osteoclasts. For instance, RANKL ligand can bind to the RANK receptor on osteoclast precursors and affect the maturation of osteoclasts. In addition, a large number of systemic and local factors from endocrine and immune systems can affect the biological functions of osteoclasts and osteoblasts.

Skeletal-related events (SREs) usually refer to major complications of tumor bone disease such as pathological fracture, spinal cord compression, hypercalcemia, the need for radiotherapy and/or surgery to bone, and so forth. Since osteoblasts and osteoclasts play important roles in bone remodeling, which is highly similar to inflammatory process, the interactions between osteoblasts, osteoclasts, malignant cells and immune cells are considered crucial for bone metastasis. Shown in previous studies, bone metastases most occurred in breast cancer patients, with mean SRE occurrence ranged from 2.2 to 4.0 per year.

Secondary osteoporosis refers to osteoporosis caused by diseases, drug treatment, or other reasons. The main clinical symptoms include osteopenia, bone microstructure changes, increased bone fragility and easy fracture. Bone mineral density (BMD) has been recognized as the gold standard for diagnosis of osteoporosis. In addition, trabecular bone structures (TBS), or TBS in combination with BMD, have also been shown clinically effective for osteoporosis and fracture management. Previous studies have suggested that bone metastasis is an important factor causing secondary osteoporosis, which is associated with decreased quality of life and increased medical costs, adding great medical burdens to the patients and our society.

The treatment strategies of secondary osteoporosis caused by various malignancies are dissimilar, but most of them involve the application of intravenous or oral bisphosphonates, and denosumab. Since secondary osteoporosis caused by bone metastasis is difficult to cure, the current treatment mainly focuses on relieving symptoms and preventing complications.

In this Research Topic, we wish to create a forum for discussion on the relationship between bone metastasis and secondary osteoporosis. We not only focus on the secondary osteoporosis induced by bone metastasis, but also pay attention to the effect of secondary osteoporosis on bone metastasis. We also welcome reviews and meta-analyses summarizing the existing research outcomes and research gaps.

Subtopics of interest include the following aspects, but not limited to:
• Mechanisms and pathways related to the relationship between bone metastasis and secondary osteoporosis
• Epidemiological/Molecular view of the association of bone metastasis and secondary osteoporosis
• Studies revealing the effects of certain malignancies on osteoporosis initiation and progression.
• Common biomarkers, risk factors, and/or treatment related to the prevention, screening, treatment, and/or prognosis of bone metastasis and secondary osteoporosis
• Analyses focused on eliminating the selective reporting biases of current publications

Types of manuscripts that are particularly welcomed:
• Randomized controlled trial with appropriate registration and ethical approval
• Well-designed observational study
• Case series
• Molecular research with animal experiment and pathway analysis
• Latest review and meta-analysis summarizing recent researches excluding retracted or suspicious studies

Types of manuscripts are:
• Case report
• Bioinformatics analysis
• In-vitro study without verification by animal experiment or clinical sample
• MicroRNA or LncRNA analysis
• Listed authors or institutions presenting history of severe academic dishonest, especially 1st or corresponding author/institution

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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