Efficacy of pamidronate in breast cancer with bone metastases: a randomized, double-blind placebo-controlled multicenter study.
OBJECTIVE
To evaluate the efficacy of pamidronate 60 mg i.v. q 4 weeks in women with advanced breast cancer with skeletal metastases.


METHODS
404 woman with skeletal metastases from breast cancer in Sweden and Norway were included in a randomized, placebo-controlled, multicenter study. Except for the study medication, other palliative treatment was chosen at the discretion of the physician. Skeletal related events, i.e. increased pain, treatment of hypercalcemia, pathologic fractures of long bones or pelvis, paralyses due to vertebral compression, palliative radiotherapy for skeletal metastases, surgery on bone and change of antitumor therapy were recorded every third month as well as a self-estimated pain-score using visual Analog Scales and analgesic consumption.


RESULTS
There was a significantly increased time to progression of pain (p < 0.01), to hypercalcemic events (p < 0.05) as well as for the cumulative number of skeletal related events (p < 0.01) in favor for the pamidronate group. No statistically significant reduction of pathologic fractures of long bones or pelvis, or pareses due to vertebral compression occurred. No statistically significant differences were found for the need of radiotherapy and surgery on bone. The pamidronate group faired better regarding performance status (p < 0.05). There was a statistically not significant lower consumption of opioid analgesics in the pamidronate group (p = 0.14).


CONCLUSIONS
Pamidronate 60 mg i.v. q 4 weeks reduces skeletal events and improves the quality of life in women with bone metastases from breast cancer.
Hultborn
R
R
Department of Oncology, Sahlgrenska University Hospital, Goteborg, Sweden.
Gundersen
S
S
Ryden
S
S
Holmberg
E
E
Carstensen
J
J
Wallgren
U B
UB
Killany
S
S
Andreassen
L
L
Carlsson
G
G
Fahl
N
N
Hatschek
T
T
Sommer
H H
HH
Hessman
Y
Y
Hornmark-Stenstam
B
B
Johnsborg
S
S
Klepp
R
R
Laino
R
R
Niklasson
L G
LG
Rudenstam
C M
CM
Sundbeck
A
A
Söderberg
M
M
Tejler
G
G
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D000077268:Pamidronate; D011788:Quality of Life; D013997:Time Factors
D000970:Antineoplastic Agents; D004164:Diphosphonates; D000077268:Pamidronate