Bone-targeted therapies (BTTs) for patients with metastatic renal cell carcinoma (mRCC) may have a continued role in the era of targeted therapy and immunotherapy, according to the authors of a paper published in Translational Oncology.

Emily C. L. Wong, MD, and Anil Kapoor, MD, of McMaster University in Hamilton, Ontario, Canada, noted that bone is the second most common site of metastasis in patients with mRCC. BTTs such as denosumab and zoledronic acid may prevent skeletal-related events (SREs), but the benefit of BTTs in combination with tyrosine kinase inhibitors (TKIs) remains unclear.

In a retrospective chart review at the Urologic Cancer Centre for Research and Innovation, Drs Wong and Kapoor studied 46 patients with mRCC who had bone metastases and had been treated with TKIs from 2010 to 2017. The primary outcome was overall survival.

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Of the 46 patients, 37 received TKIs only and 9 received TKIs plus BTT (either denosumab or zoledronic acid). At the time of the investigators’ analysis, 63% of patients had died. Median overall survival (OS) was longer among patients in the BTT group (29.6 vs 13.8 months).

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“Although the difference in median OS was not statistically significant, a 16-month improvement observed in the BTT + TKI group may be clinically significant,” Drs Wong and Kapoor wrote.

They also noted, “Given the resurgence of immunotherapy and development of new targeted therapies for mRCC, the treatment paradigm for bone metastases will continue to evolve.”


Wong ECL, Kapoor A. Does bone-targeted therapy benefit patients with metastatic renal cell carcinoma? Transl Oncol. 2019;13:241-244.

doi: 10.1016/j.tranon.2019.10.009