Malignant skeletal pain: Mechanisms and potential therapeutic opportunities

For the first time, animal models of cancer pain are now available and effectively mirror the clinical picture observed in humans with bone cancer pain. Information generated from these models has begun to provide insight into the mechanisms that generate and maintain bone cancer pain and helped target potential mechanism-based therapies to treat this chronic pain state. It is noteworthy that in these models analgesics such as a bisphosphonate, osteoprotegerin and a cyclooxygenase-2 inhibitor appear to influence disease progression in the tumor-bearing bone. Together these and other studies using models of bone cancer suggest that it may be possible to develop novel mechanism-based therapies that not only reduce tumor-induced bone pain but may provide added benefit in synergistically reducing disease progression. Successful development and clinical use of these therapies has the potential not only to positively impact survival, but also to improve the cancer patient's quality of life.