The development of osteoclastic and osteoblastic bone metastases. Tumor cells interact with both osteoclasts and osteoblasts in the bone microenvironment, which leads to a local increase in tumor-derived factors to promote osteoclastogenesis and osteoblastogenesis. Mature osteoclasts, in turn, release survival factors, such as insulin-like growth factor 1 (IGF-1) and transforming growth factor beta (TGF-β), which promote the survival and proliferation of tumor cells
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