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New cancer ‘wonder’ drugs trigger cancer spread to bones: Most cancer drugs are used to hopefully kill tumors and keep malignancies from spreading. Unfortunately, new research from the Washington University School of Medicine in St. Louis raises serious concerns that Big Pharma’s highly touted class of cancer drugs known as IAP antagonists actually increases the risk of tumors spreading to bone.
“These investigational drugs are getting broad attention right now because they seem to be very effective against primary tumors,” senior author Deborah V. Novack, MD, PhD, associate professor of medicine, said in a media statement “There is also excitement because until now, these drugs have not appeared to have major side effects.”
However, the study by Novack and her research team (just published in the journal Cancer Discovery) reveals that while the IAP drugs target a protein that makes tumors vulnerable to death, the same protein also over-activates cells called osteoclasts which are responsible for tearing down bone. The risk for patients? Potentially, IAPs can trigger the bone weakening disease osteoporosis and, even more worrisome, they may cause metastasis of cancer to the bones.
Numerous IAP antagonists are already in early clinical trials against breast, lung, pancreatic, ovarian, prostate, liver, skin and blood cancers. While these phase one or two clinical trials look at the short-term safety and effectiveness of new drugs, the researchers say they may not catch bone metastasis. “These trials do not necessarily look for long-term effects of the drugs,” Chang Yang, MD, PhD, staff scientist and the paper’s first author said in the press statement. “If the cancer is going to metastasize to bone, it may take six months to two years to see that outcome. This may not be seen during the clinical trial.”
Due to the study’s findings, Novack has gone on record urging cancer specialists oncologists to consider protecting the bones in people taking IAP antagonists, including patients with cancers that don’t typically spread to bone. “For many of these cancers, doctors are not watching bone,” Novack says. “Osteoporosis is not the biggest concern when treating cancer, but if they’re not doing bone scans, they may miss a cancer spreading to bone.”
Normally, osteoclasts work alongside other normal cells to build new bone. But because IAP antagonists over-activate osteoclasts,
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