Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Which agents may be added to cancer treatment regimens to prevent further bone injury from metastases?

1. Denosumab and Steroids

2. Bisphosphonates and Denosumab

3. Antibiotics and Bisphosphonates

4. Radiation and Chemotherapy

The correct answer is: Bisphosphonates and Denosumab

The correct response highlights the role of bisphosphonates and denosumab in preventing further bone injury caused by metastatic cancer. These agents are specifically designed to manage bone health in patients who have experienced bone metastases from various cancers. Bisphosphonates, such as zoledronic acid and pamidronate, work by inhibiting osteoclast-mediated bone resorption. This helps to maintain bone density and reduce the occurrence of skeletal-related events (like fractures) associated with bone metastases. They are critical in the management of patients with metastatic disease to the bones, effectively lowering the risk of complications associated with weakened bone structure. Denosumab is a monoclonal antibody that functions similarly but works by inhibiting a protein known as RANKL, which is essential for osteoclast formation, function, and survival. By blocking RANKL, denosumab effectively decreases bone resorption and improves bone stability, making it another compelling option for patients with bone metastases. In comparison, while steroids may be used to manage symptoms associated with cancer and its treatment or inflammation, they do not specifically address bone injury resulting from metastases. Antibiotics are not relevant in this context as their primary purpose is to treat infections rather than manage bone