Academic Journal
Systemic management of spinal metastases: current strategies and future directions.
| Τίτλος: | Systemic management of spinal metastases: current strategies and future directions. |
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| Συγγραφείς: | Collin H; Department of Medical Oncology, University Hospital of Tours, Tours, France; Inserm UMR1069, N2COx, Tours University, Tours, France., Muller S; Department of Medical Oncology, University Hospital of Tours, Tours, France., Ferreira M; Department of Pneumology and Respiratory Functional Exploration, University Hospital of Tours, Tours, France; INSERM U1100, Centre d'Etude des Pathologies Respiratoires, Tours University, Tours, France., Cancel M; Department of Medical Oncology, University Hospital of Tours, Tours, France; Inserm UMR1069, N2COx, Tours University, Tours, France. Electronic address: mathilde.cancel@univ-tours.fr. |
| Πηγή: | Neuro-Chirurgie [Neurochirurgie] 2026 May; Vol. 72 (3), pp. 101809. Date of Electronic Publication: 2026 Apr 09. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Masson Country of Publication: France NLM ID: 0401057 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1773-0619 (Electronic) Linking ISSN: 00283770 NLM ISO Abbreviation: Neurochirurgie Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Paris : Masson |
| Ιατρικοί όροι (MeSH): | Spinal Neoplasms*/secondary , Spinal Neoplasms*/therapy, Combined Modality Therapy/methods ; Bone Density Conservation Agents/therapeutic use ; Immunotherapy/methods ; Bone Neoplasms/secondary ; Humans |
| Περίληψη: | Bones are a common dissemination site in prostate, breast, lung, and renal cancers. Bone metastases are associated with significant morbidity and reduced overall survival. The spine is the most frequently involved site, where metastases can lead to skeletal-related events (SREs) such as pain, pathological fractures, and spinal cord compression. Management of spinal metastases (SM) relies on a multidisciplinary approach combining local treatments (surgery, radiotherapy, interventional procedures) and systemic therapies. Bone-targeting agents, including bisphosphonates and denosumab, have demonstrated efficacy in reducing SRE incidence, although their use remains suboptimal in clinical practice. Conventional systemic therapies such as chemotherapy and endocrine therapy may negatively impact bone health and show limited efficacy in controlling SM. Immune checkpoint inhibitors have transformed the treatment landscape of several metastatic cancers, yet their activity in bone metastases appears reduced, likely due to the specific bone microenvironment. Targeted therapies represent the most promising systemic approach, with variable but sometimes significant activity in SM depending on tumor type and molecular profile. Optimal management of SM requires individualized, multidisciplinary strategies to optimize systemic disease control, local tumor management, and prevention of SREs. (Copyright © 2026 The Authors. Published by Elsevier Masson SAS.. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial or personal relationships that could be viewed as influencing the work reported in this paper. |
| Contributed Indexing: | Keywords: Bone-modifying agents; Chemotherapy; Immunotherapy; Multidisciplinary tumor board; Spinal metastases; Systemic therapy; Targeted therapy |
| Substance Nomenclature: | 0 (Bone Density Conservation Agents) |
| Entry Date(s): | Date Created: 20260412 Date Completed: 20260714 Latest Revision: 20260714 |
| Update Code: | 20260715 |
| DOI: | 10.1016/j.neuchi.2026.101809 |
| PMID: | 41966256 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1773-0619 |
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| DOI: | 10.1016/j.neuchi.2026.101809 |