The vicious cycle

• RANK L in healthy bone
  • Balancing resorption and formation
  • RL is essential to osteoclast function
  • RANK Ligand and OPG balance bone loss and formation
• RANK L in metastatic bone disease
  • Osteoblastic vs osteolytic bone mets
  • RL drives the vicious cycle
• Bone metastases and SREs
  • Incidence of mets
  • Incidence of SREs
  • Subsequent SREs
  • Bone pain and mets
• Prostate cancer
  • Bone metastases and skeletal-related events (SREs) in prostate cancer.
  • The skeleton is the most common site affected by metastatic prostate cancer⁵
• Breast cancer
  • SREs in breast cancer
  • Subsequent SREs
  • SREs increase mortality in breast
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