Ibandronate: its pharmacology and clinical efficacy in the management of tumor-induced hypercalcemia and metastatic bone disease.
It is well accepted that tumor cells in the bone, especially from breast cancer, prostate cancer and multiple myeloma, can stimulate osteoclast formation and activity. Bisphosphonates are potent inhibitors of osteoclast-mediated normal and pathologic bone resorption. Besides their apoptotic and antiproliferative activity on osteoclasts, bisphosphonates can also exert similar effects on macrophages and tumor cells. Currently, it is unknown if this effect can be translated into clinical practice with regard to an effective adjuvant therapeutic regimen for high-risk patients with systemic recurrences following primary treatment of a given cancer. There are several new aspects that might extend the clinical use of ibandronate, a bisphosphate, in oncology: prevention of hypogonadal osteoporosis in men, palliative management of painful osseous metastases and adjuvant therapy of high-risk prostate cancer patients. Safety and tolerability are excellent for the oral and intravenous formulations, and ibandronate can even be safely applied in pre-existing renal insufficiency. The purpose of this review is to critically reflect the pharmacology and clinical efficacy of ibandronate in the management of tumor-induced hypercalcemia, osteoporosis and metastatic bone disease.
Heidenreich
Axel
A
Division of Oncological Urology, Department of Urology, University of Cologne, Joseph-Stelzmann-Str. 9, 50924 Köln, Germany. axel.heidenreich@uk-koeln.de
Ohlmann
Carsten H
CH
D000284:Administration, Oral; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000556:secondary*; D001862:Bone Resorption; D004164:Diphosphonates / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology*; D000077557:Ibandronic Acid; D007262:Infusions, Intravenous; D009369:Neoplasms / Q000150:complications; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology*; D011358:Product Surveillance, Postmarketing; D012307:Risk Factors
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077557:Ibandronic Acid