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Bone mineral at sites of increased osteogenesis within metastatic lesions represents newly deposited yet structurally inferior hydroxyapatite/collagen composite laid down under dysregulated conditions induced primarily by cancer-bone interactions. It is an important target for imaging diagnostics—and potentially therapy—in patients with advanced malignancies affecting the skeleton. The newly formed mineral at these sites tends to have a lower degree of mineralization, altered crystal structure, and reduced enzymatic collagen crosslinks, leading to mechanically weaker bone despite increased density on imaging.
Bisphosphonates: Inhibit osteoclast-mediated bone resorption. Denosumab: RANKL inhibitor, preventing osteoclast formation and activity.
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