{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:38:16Z","timestamp":1793151496328,"version":"4.5.0"},"reference-count":107,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The standard care for metastatic breast cancer (MBC) is systemic therapies with imbrication of focal treatment for symptoms. Recently, thanks to implementation of radiological and metabolic exams and development of new target therapies, oligometastatic and oligoprogressive settings are even more common\u2014paving the way to a paradigm change of focal treatments role. In fact, according to immunophenotype, radiotherapy can be considered with radical intent in these settings of patients. The aim of this literature review is to analyze available clinical data on prognosis of bone metastases from breast cancer and benefits of available treatments for developing a practical guide for clinicians.<\/jats:p>","DOI":"10.3390\/cancers12092390","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T10:37:32Z","timestamp":1598265452000},"page":"2390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Diagnosis and Treatment of Bone Metastases in Breast Cancer: Radiotherapy, Local Approach and Systemic Therapy in a Guide for Clinicians"],"prefix":"10.3390","volume":"12","author":[{"given":"Fabio","family":"Marazzi","sequence":"first","affiliation":[{"name":"\u201cA. Gemelli\u201d IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5253-4678","authenticated-orcid":false,"given":"Armando","family":"Orlandi","sequence":"additional","affiliation":[{"name":"\u201cA. Gemelli\u201d IRCCS, UOC di Oncologia Medica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4266-8255","authenticated-orcid":false,"given":"Stefania","family":"Manfrida","sequence":"additional","affiliation":[{"name":"\u201cA. 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Survival Rates for Breast Cancer. Available online: https:\/\/www.cancer.org\/cancer\/breast-cancer\/understanding-a-breast-cancer-diagnosis\/breast-cancer-survival-rates.html."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/s41572-019-0111-2","article-title":"Breast cancer","volume":"5","author":"Harbeck","year":"2019","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hernandez, R.K., Wade, S.W., Reich, A., Pirolli, M., Liede, A., and Lyman, G.H. (2018). Incidence of bone metastases in patients with solid tumors: Analysis of oncology electronic medical records in the United States. BMC Cancer, 18.","DOI":"10.1186\/s12885-017-3922-0"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"27990","DOI":"10.18632\/oncotarget.15856","article-title":"Breast cancer subtypes predict the preferential site of distant metastases: A SEER based study","volume":"8","author":"Wu","year":"2017","journal-title":"Oncotarget"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00428-017-2065-7","article-title":"Breast carcinoma subtypes show different patterns of metastatic behavior","volume":"470","author":"Fekete","year":"2017","journal-title":"Virchows Arch."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/S1470-2045(19)30718-1","article-title":"Characterisation and classification of oligometastatic disease: A European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation","volume":"21","author":"Guckenberger","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New Response Evaluation Criteria in Solid Tumours: Revised RECIST Guideline (Version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1002\/(SICI)1097-0142(19971015)80:8+<1546::AID-CNCR4>3.0.CO;2-I","article-title":"Mechanisms of Bone Metastasis","volume":"80","author":"Mundy","year":"1997","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100205","DOI":"10.1016\/j.jbo.2018.10.004","article-title":"Metastatic bone disease: Pathogenesis and therapeutic options","volume":"15","author":"Coleman","year":"2019","journal-title":"J. Bone Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1387\/ijdb.041817lv","article-title":"Pain control by ionizing radiation of bone metastasis","volume":"48","author":"Vakaet","year":"2004","journal-title":"Int. J. Dev. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s00520-018-4335-6","article-title":"IMproved MAnagement (IM-MA study) in cancer-related pain: The value of a joint approach by an integrated team of radiotherapist and anesthetist","volume":"27","author":"Manfrida","year":"2019","journal-title":"Support Care Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S1470-2045(15)00613-0","article-title":"Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): Final analysis of the multicentre, double-blind, phase 3 randomised controlled trial","volume":"17","author":"Cristofanilli","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1001\/jama.1994.03510440047031","article-title":"Impact of Follow-up Testing on Survival and Health-Related Quality of Life in Breast Cancer Patients A Multicenter Randomized Controlled Trial","volume":"271","author":"Ghezzi","year":"1994","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1001\/jama.1994.03510440053032","article-title":"Intensive Diagnostic Follow-up After Treatment of Primary Breast Cancer. A Randomized Trial","volume":"271","author":"Palli","year":"1994","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.radonc.2018.11.022","article-title":"Oligometastatic breast cancer treated with hypofractionated stereotactic radiotherapy: Some patients survive longer than a decade","volume":"131","author":"Milano","year":"2019","journal-title":"Radiother. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s12282-012-0347-0","article-title":"Possible clinical cure of metastatic breast cancer: Lessons from our 30-year experience with oligometastatic breast cancer patients and literature review","volume":"19","author":"Kobayashi","year":"2012","journal-title":"Breast Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/nrc867","article-title":"Metastasis to bone: Causes, consequences and therapeutic opportunities","volume":"2","author":"Mundy","year":"2002","journal-title":"Nat. Rev. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0167-8140(02)00170-6","article-title":"International consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases","volume":"64","author":"Chow","year":"2002","journal-title":"Radiother. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1016\/j.ijrobp.2011.02.008","article-title":"Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases","volume":"82","author":"Chow","year":"2012","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3389\/fonc.2019.00337","article-title":"Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Spine Metastases: An Overview","volume":"9","author":"Zeng","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1056\/NEJMcibr1701388","article-title":"Timing of Metastasis in Breast Cancer","volume":"376","author":"Schwartz","year":"2017","journal-title":"N. Engl. J. Med"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1038\/nature20785","article-title":"Early dissemination seeds metastasis in breast cancer","volume":"540","author":"Hosseini","year":"2016","journal-title":"Nature"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1038\/nature20609","article-title":"Mechanism of early dissemination and metastasis in Her2+ mammary cancer","volume":"540","author":"Harper","year":"2016","journal-title":"Nature"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ejrad.2005.01.016","article-title":"Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET\/CT for the detection of metastases of bone","volume":"55","author":"Ghanem","year":"2005","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4329\/wjr.v7.i8.202","article-title":"Imaging of bone metastasis: An update","volume":"7","year":"2015","journal-title":"WJR"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1038\/bjc.2015.8","article-title":"Early detection of metastatic disease in asymptomatic breast cancer patients with whole-body imaging and defined tumour marker increase","volume":"112","author":"Stieber","year":"2015","journal-title":"Br. J. Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"799","DOI":"10.2967\/jnumed.119.234260","article-title":"Molecular imaging of bone metastases and their response to therapy","volume":"61","author":"Cook","year":"2020","journal-title":"J. Nucl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Stecco, A., Trisoglio, A., Soligo, E., Berardo, S., Sukhovei, L., and Carriero, A. (2018). Whole-Body MRI with Diffusion-Weighted Imaging in Bone Metastases: A Narrative Review. Diagnostics, 8.","DOI":"10.3390\/diagnostics8030045"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S1470-2045(09)70088-9","article-title":"Imaging bone metastases in breast cancer: Techniques and recommendations for diagnosis","volume":"10","author":"Costelloe","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s12149-018-01323-8","article-title":"Response evaluation with 18F-FDG PET\/CT in metastatic breast cancer patients treated with Palbociclib: First experience in clinical practice","volume":"33","author":"Taralli","year":"2019","journal-title":"Ann. Nucl. Med."},{"key":"ref_33","unstructured":"National Comprehensive Cancer Network (2020). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Breast Cancer, National Comprehensive Cancer Network. version 2."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.1007\/s00330-011-2221-4","article-title":"Diagnosis of bone metastases: A meta-analysis comparing 18FDG PET, CT, MRI and bone scintigraphy","volume":"21","author":"Yang","year":"2011","journal-title":"Eur. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.2214\/AJR.11.7498","article-title":"Can Sarcoidosis and Metastatic Bone Lesions Be Reliably Differentiated on Routine MRI?","volume":"198","author":"Moore","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e146","DOI":"10.1097\/RLU.0b013e318279f264","article-title":"Functional Imaging in Extrapulmonary Sarcoidosis: FDG-PET\/CT and MR Features","volume":"39","author":"Soussan","year":"2014","journal-title":"Clin. Nucl. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1093\/neuros\/nyy059","article-title":"Histopathological Findings After Reirradiation Compared to First Irradiation of Spinal Bone Metastases with Stereotactic Body Radiotherapy: A Cohort Study","volume":"84","author":"Foerster","year":"2019","journal-title":"Neurosurgery"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1634\/theoncologist.2012-0092","article-title":"Review and Uses of Stereotactic Body Radiation Therapy for Oligometastases","volume":"17","author":"Alongi","year":"2012","journal-title":"Oncologist"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"587","DOI":"10.3389\/fendo.2019.00587","article-title":"Therapeutic Irradiation: Consequences for Bone and Bone Marrow Adipose Tissue","volume":"10","author":"Costa","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1667\/RR3108","article-title":"Radiation Treatment Decreases Bone Cancer Pain, Osteolysis and Tumor Size","volume":"161","author":"Goblirsch","year":"2004","journal-title":"Radiat. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1093\/jrr\/rrx026","article-title":"Differences in responses to X-ray exposure between osteoclast and osteoblast cells","volume":"58","author":"Zhang","year":"2017","journal-title":"J. Radiat. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/j.ijrobp.2018.01.005","article-title":"Early Tissue Effects of Stereotactic Body Radiation Therapy for Spinal Metastases","volume":"100","author":"Steverink","year":"2018","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1016\/0360-3016(85)90027-6","article-title":"Analysis of tumor parameters, tumor dose and local control: The experience of the Gustave-Roussy Institute and the Princess Margaret Hospital","volume":"11","author":"Arriagada","year":"1985","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1002\/cncr.21467","article-title":"Single-fraction radiosurgery for the treatment of spinal breast metastases","volume":"104","author":"Gerszten","year":"2005","journal-title":"Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s12282-018-0921-1","article-title":"Oligometastatic breast cancer","volume":"26","author":"Kwapisz","year":"2019","journal-title":"Breast Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1200\/JCO.2006.09.5281","article-title":"Palliative Radiotherapy Trials for Bone Metastases: A Systematic Review","volume":"25","author":"Chow","year":"2007","journal-title":"JCO"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1002\/cncr.20633","article-title":"A prospective evaluation of two radiotherapy schedules with 10 versus 20 fractions for the treatment of metastatic spinal cord compression: Final results of a multicenter study","volume":"101","author":"Rades","year":"2004","journal-title":"Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1093\/annonc\/mdt537","article-title":"Stereotactic radiotherapy for oligometastatic cancer: A prognostic model for survival","volume":"25","author":"Engels","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1016\/S1470-2045(12)70510-7","article-title":"Stereotactic body radiotherapy for oligometastases","volume":"14","author":"Tree","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1186\/s13063-019-3676-x","article-title":"Pain REduction with bone metastases STereotactic radiotherapy (PREST): A phase III randomized multicentric trial","volume":"20","author":"Cellini","year":"2019","journal-title":"Trials"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3857\/roj.2015.33.4.301","article-title":"Prognostic factors in breast cancer with extracranial oligometastases and the appropriate role of radiation therapy","volume":"33","author":"Yoo","year":"2015","journal-title":"Radiat. Oncol. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.radonc.2017.08.032","article-title":"Radical radiation therapy for oligometastatic breast cancer: Results of a prospective phase II trial","volume":"126","author":"Trovo","year":"2018","journal-title":"Radiother. Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/ajco.13115","article-title":"Utilization of stereotactic ablative radiotherapy in oligometastatic & oligoprogressive skeletal metastases: Results and pattern of failure","volume":"15","author":"Kam","year":"2019","journal-title":"Asia-Pac. J. Clin. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1016\/j.prro.2018.10.008","article-title":"Outcomes after Hypofractionated Dose-Escalation using a Simultaneous Integrated Boost Technique for Treatment of Spine Metastases Not Amenable to Stereotactic Radiosurgery","volume":"9","author":"Farooqi","year":"2019","journal-title":"Pract. Radiat. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1002\/cncr.23888","article-title":"Prognostic factors and a scoring system for survival after radiotherapy for metastases to the spinal column: A review of 544 patients at Shizuoka Cancer Center Hospital","volume":"113","author":"Mizumoto","year":"2008","journal-title":"Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1002\/cncr.30058","article-title":"Clinical and molecular markers of long-term survival after oligometastasis-directed stereotactic body radiotherapy (SBRT): Survival after SBRT for Oligometastases","volume":"122","author":"Wong","year":"2016","journal-title":"Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0167-8140(97)00116-3","article-title":"Simultaneous high-dose external irradiation and daily cisplatin in unresectable, non-metastatic adenocarcinoma of the pancreas: A phase I\u2013II study","volume":"45","author":"Nguyen","year":"1997","journal-title":"Radiother. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.rpor.2019.12.019","article-title":"Radiation Therapy for Bone-Only Metastases in Breast Cancer Patients: A GOCO Survey of Current Clinical Practice","volume":"25","author":"Bonet","year":"2020","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1093\/annonc\/mdy192","article-title":"4th ESO\u2013ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)","volume":"29","author":"Cardoso","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s10549-007-9776-4","article-title":"Taxane vs. taxane: Is the duel at an end? A commentary on a phase-III trial of doxorubicin and docetaxel versus doxorubicin and paclitaxel in metastatic breast cancer: Results of the ERASME 3 study","volume":"111","author":"Radaideh","year":"2008","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1200\/JCO.2003.08.013","article-title":"Phase III Trial of Doxorubicin, Paclitaxel, and the Combination of Doxorubicin and Paclitaxel as Front-Line Chemotherapy for Metastatic Breast Cancer: An Intergroup Trial (E1193)","volume":"21","author":"Sledge","year":"2003","journal-title":"JCO"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/S0140-6736(11)60070-6","article-title":"Eribulin monotherapy versus treatment of physician\u2019s choice in patients with metastatic breast cancer (EMBRACE): A phase 3 open-label randomised study","volume":"377","author":"Cortes","year":"2011","journal-title":"Lancet"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.1200\/JCO.2008.18.5397","article-title":"Significantly Longer Progression-Free Survival With nab -Paclitaxel Compared with Docetaxel as First-Line Therapy for Metastatic Breast Cancer","volume":"27","author":"Gradishar","year":"2009","journal-title":"JCO"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1200\/jco.2004.22.90140.510","article-title":"Global phase III study of gemcitabine plus paclitaxel (GT) vs. paclitaxel (T) as frontline therapy for metastatic breast cancer (MBC): First report of overall survival","volume":"22","author":"Albain","year":"2004","journal-title":"J. Clin. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1186\/s13063-015-1101-7","article-title":"Phase II\/III weekly nab-paclitaxel plus gemcitabine or carboplatin versus gemcitabine\/carboplatin as first-line treatment of patients with metastatic triple-negative breast cancer (the tnAcity study): Study protocol for a randomized controlled trial","volume":"16","author":"Yardley","year":"2015","journal-title":"Trials"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1093\/annonc\/mdu456","article-title":"Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: Overall survival results from BOLERO-2","volume":"25","author":"Piccart","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1056\/NEJMoa1813904","article-title":"Alpelisib for PIK3CA -Mutated, Hormone Receptor\u2013Positive Advanced Breast Cancer","volume":"380","author":"Ciruelos","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1056\/NEJMoa1607303","article-title":"Palbociclib and Letrozole in Advanced Breast Cancer","volume":"375","author":"Finn","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3638","DOI":"10.1200\/JCO.2017.75.6155","article-title":"MONARCH 3: Abemaciclib as Initial Therapy for Advanced Breast Cancer","volume":"35","author":"Goetz","year":"2017","journal-title":"JCO"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/S1470-2045(18)30292-4","article-title":"Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): A randomised phase 3 trial","volume":"19","author":"Tripathy","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s11060-019-03260-6","article-title":"CDK 4\/6 inhibitors and stereotactic radiation in the management of hormone receptor positive breast cancer brain metastases","volume":"144","author":"Figura","year":"2019","journal-title":"J. Neurooncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.rpor.2019.03.001","article-title":"Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report","volume":"24","author":"Messer","year":"2019","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.adro.2019.03.011","article-title":"Safety and Efficacy of Palbociclib and Radiation Therapy in Patients with Metastatic Breast Cancer: Initial Results of a Novel Combination","volume":"4","author":"Chowdhary","year":"2019","journal-title":"Adv. Radiat. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.breast.2019.05.001","article-title":"Concurrent radiotherapy with palbociclib or ribociclib for metastatic breast cancer patients: Preliminary assessment of toxicity","volume":"46","author":"Ippolito","year":"2019","journal-title":"Breast"},{"key":"ref_75","first-page":"1113","article-title":"Sensitization of breast cancer cells to radiation by trastuzumab","volume":"2","author":"Liang","year":"2003","journal-title":"Mol. Cancer Ther."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1038\/sj.onc.1207149","article-title":"Expression of ErbB2 enhances radiation-induced NF-\u03baB activation","volume":"23","author":"Guo","year":"2004","journal-title":"Oncogene"},{"key":"ref_77","first-page":"1347","article-title":"Monoclonal antibody to HER-2\/neureceptor modulates repair of radiation-induced DNA damage and enhances radiosensitivity of human breast cancer cells overexpressing this oncogene","volume":"59","author":"Pietras","year":"1999","journal-title":"Cancer Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"45186","DOI":"10.18632\/oncotarget.9870","article-title":"HER2 reduces breast cancer radiosensitivity by activating focal adhesion kinase in vitro and in vivo","volume":"7","author":"Hou","year":"2016","journal-title":"Oncotarget"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1530\/ERC-13-0019","article-title":"Targeting focal adhesion kinase in ER+\/HER2+ breast cancer improves trastuzumab response","volume":"20","author":"Lazaro","year":"2013","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"7055","DOI":"10.18632\/oncotarget.6855","article-title":"STAT3-survivin signaling mediates a poor response to radiotherapy in HER2-positive breast cancers","volume":"7","author":"Kim","year":"2016","journal-title":"Oncotarget"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ijrobp.2004.05.017","article-title":"Monoclonal antibody to HER-2\/neu receptor enhances radiosensitivity of esophageal cancer cell lines expressing HER-2\/neu oncoprotein","volume":"61","author":"Sato","year":"2005","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1002\/ijc.1493","article-title":"Anti-HER2-antibody enhances irradiation-induced growth inhibition in head and neck carcinoma","volume":"94","author":"Uno","year":"2001","journal-title":"Int. J. Cancer"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1007\/s12032-009-9395-5","article-title":"The impact of trastuzumab on radiation-induced pulmonary fibrosis: Results of an experimental study","volume":"27","author":"Bese","year":"2010","journal-title":"Med. Oncol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ijrobp.2009.12.063","article-title":"Lapatinib in Combination with Radiation Diminishes Tumor Regrowth in HER2+ and Basal-Like\/EGFR+ Breast Tumor Xenografts","volume":"77","author":"Sambade","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.radonc.2009.09.006","article-title":"Mechanism of lapatinib-mediated radiosensitization of breast cancer cells is primarily by inhibition of the Raf > MEK > ERK mitogen-activated protein kinase cascade and radiosensitization of lapatinib-resistant cells restored by direct inhibition of MEK","volume":"93","author":"Sambade","year":"2009","journal-title":"Radiother. Oncol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"13019","DOI":"10.1038\/ncomms13019","article-title":"Anti-tubulin drugs conjugated to anti-ErbB antibodies selectively radiosensitize","volume":"7","author":"Adams","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1634\/theoncologist.2012-0256","article-title":"Phase I Study and Biomarker Analysis of Lapatinib and Concurrent Radiation for Locally Advanced Breast Cancer","volume":"17","author":"Kimple","year":"2012","journal-title":"Oncologist"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1200\/JCO.2014.58.7782","article-title":"Feasibility and Cardiac Safety of Trastuzumab Emtansine After Anthracycline-Based Chemotherapy As (neo)Adjuvant Therapy for Human Epidermal Growth Factor Receptor 2\u2013Positive Early-Stage Breast Cancer","volume":"33","author":"Krop","year":"2015","journal-title":"JCO"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"3349","DOI":"10.1038\/onc.2014.295","article-title":"The role of poly(ADP-ribosyl)ation in DNA damage response and cancer chemotherapy","volume":"34","author":"Yu","year":"2015","journal-title":"Oncogene"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"3551","DOI":"10.1111\/febs.12290","article-title":"A role of intracellular mono-ADP-ribosylation in cancer biology","volume":"280","author":"Scarpa","year":"2013","journal-title":"FEBS J."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Dulaney, C., Marcrom, S., Stanley, J., and Yang, E.S. (2017). Poly(ADP-ribose) Polymerase Activity and Inhibition in Cancer. Seminars in Cell & Developmental Biology, Academic Press.","DOI":"10.1016\/j.semcdb.2017.01.007"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"69105","DOI":"10.18632\/oncotarget.19079","article-title":"Poly-(ADP-ribose)-polymerase inhibitors as radiosensitizers: A systematic review of pre-clinical and clinical human studies","volume":"8","author":"Lesueur","year":"2017","journal-title":"Oncotarget"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"433","DOI":"10.5301\/tj.5000558","article-title":"The Current Status of PARP Inhibitors in Ovarian Cancer","volume":"102","author":"McLachlan","year":"2016","journal-title":"Tumori J."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1056\/NEJMoa1809615","article-title":"Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer","volume":"379","author":"Schmid","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_95","first-page":"1","article-title":"Radiometabolic Treatment of Bone-Metastasizing Cancer: From 186Rhenium to 223Radium","volume":"29","author":"Rubini","year":"2014","journal-title":"Cancer Biother. Radiopharm."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/00006231-200007000-00004","article-title":"Usefulness of strontium-89 for bone pain palliation in metastatic breast cancer patients","volume":"21","author":"Fuster","year":"2000","journal-title":"Nucl. Med. Commun."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1007\/s00259-004-1539-4","article-title":"186Re-HEDP for metastatic bone pain in breast cancer patients","volume":"31","author":"Lam","year":"2004","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/00003072-199909000-00001","article-title":"Pain Palliation With rhenium-186 HEDP in Breast Cancer Patients With Disseminated Bone Metastases","volume":"24","author":"Palmedo","year":"1999","journal-title":"Clin. Nucl. Med."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"4451","DOI":"10.1158\/1078-0432.CCR-04-2244","article-title":"First Clinical Experience With Alpha-Emitting radium-223 in the Treatment of Skeletal Metastases","volume":"11","author":"Nilsson","year":"2005","journal-title":"Clin. Cancer Res."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s10549-014-2939-1","article-title":"A phase IIa, nonrandomized study of radium-223 dichloride in advanced breast cancer patients with bone-dominant disease","volume":"145","author":"Coleman","year":"2014","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13063-019-3643-6","article-title":"CApecitabine plus Radium-223 (XofigoTM) in breast cancer patients with BONe metastases (CARBON): Study protocol for a phase IB\/IIA randomised controlled trial","volume":"21","author":"Coleman","year":"2020","journal-title":"Trials"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jmbbm.2016.12.017","article-title":"The impact of metastasis on the mineral phase of vertebral bone tissue","volume":"69","author":"Burke","year":"2017","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s10147-005-0478-9","article-title":"Surgical treatment of bone metastasis: Indications and outcomes","volume":"10","author":"Manabe","year":"2004","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00003086-200203000-00029","article-title":"Surgical Treatment of Bone Metastases in Patients with Breast Cancer","volume":"396","author":"Durr","year":"2002","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1302\/2058-5241.2.170006","article-title":"Diagnostic algorithm, prognostic factors and surgical treatment of metastatic cancer diseases of the long bones and spine","volume":"2","author":"Antal","year":"2017","journal-title":"EFORT Open Rev."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e12741","DOI":"10.1111\/ecc.12741","article-title":"Interventional radiology in bone metastases","volume":"26","author":"Chiras","year":"2017","journal-title":"Eur. J. 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