3(Amino-1,1-hydroxypropylidene) bisphosphonate (APD) for hypercalcaemia of breast cancer.
The effect of a single dose of APD on hypercalcaemia has been studied in advanced breast cancer. Twenty-five patients were rehydrated intravenously for 48 h. Twenty-three remained hypercalcaemic and received 5-15 mg APD as a 2 h infusion. Eighteen patients achieved normocalcaemia, 15 after a dose of less than or equal to 15 mg. One patient died within 24 h from rapidly advancing disease and 4 remained hypercalcaemic. Urinary calcium excretion increased during rehydration as glomerular function improved and tubular reabsorption of calcium fell. After APD, calcium excretion fell to normal in 22/24 patients reflecting inhibition of bone resorption. Hydroxyproline excretion remained high. The effect of a single dose of APD on hypercalcaemia lasted a median of 11 days (range 7-17). Transient fever occurred in 2 patients, but there were no other side effects. The possibility of long-term control of osteolysis using a 2 weekly schedule of APD administration is now being studied.
Coleman
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Imperial Cancer Research Fund Clinical Oncology Unit, Guy's Hospital, London, UK.
Rubens
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D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000652:urine; D002118:Calcium / Q000652:urine; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D006934:Hypercalcemia / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D010014:Osteolysis / Q000517:prevention & control; D000077268:Pamidronate; D013997:Time Factors
D004164:Diphosphonates; D000077268:Pamidronate; D006909:Hydroxyproline; D002118:Calcium