Single-agent pamidronate for palliative therapy of canine appendicular osteosarcoma bone pain.
BACKGROUND
Canine appendicular osteosarcoma (OSA) causes focal bone destruction, leading to chronic pain and reduced quality-of-life scores. Drugs that inhibit pathologic osteolysis might provide additional treatment options for managing cancer-induced bone pain. Aminobisphosphonates induce osteoclast apoptosis, thereby reducing pain associated with malignant osteolysis in human patients with cancer.


OBJECTIVE
Treatment of dogs with pamidronate administered intravenously will alleviate bone pain and reduce pathologic bone turnover associated with appendicular OSA in dogs.


METHODS
Forty-three dogs with naturally occurring appendicular OSA administered pamidronate intravenously.


METHODS
Prospective study. Therapeutic responses in dogs treated with pamidronate administered intravenously and nonsteroidal anti-inflammatory drugs (NSAID) were evaluated by using a numerical cumulative pain index score (CPIS), and by quantifying urine N-telopeptide (NTx) excretion and relative primary tumor bone mineral density (rBMD) assessed with dual energy x-ray absorptiometry. In addition, variables, including pamidronate dose, skeletal mass, baseline and change for CPIS, urine NTx and rBMD during treatment, and baseline tumor volume and radiographic pattern were compared between dogs clinically responsive and nonresponsive to pamidronate therapy.


RESULTS
Twelve of 43 dogs (28%) had pain alleviation for >4 months, lasting a median of 231 days. Changes in CPIS and rBMD during treatment were statistically different between responders and nonresponders (P = .046 and .03, respectively).


CONCLUSIONS
Substantiated by reductions in CPIS and increases in rBMD, single-agent pamidronate administered intravenously with NSAID therapy relieves pain and diminishes pathologic bone turnover associated with appendicular OSA in a subset of dogs.
Fan
Timothy M
TM
Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802-4714, USA. t-fan@uiuc.edu
de Lorimier
Louis-Philippe
LP
O'Dell-Anderson
Kristen
K
Lacoste
Hugues I
HI
Charney
Sarah C
SC
D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000652:urine; D015519:Bone Density / Q000187:drug effects; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy / Q000662:veterinary*; D024042:Collagen Type I / Q000652:urine; D004164:Diphosphonates / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy* / Q000209:etiology; D004285:Dogs; D005260:Female; D007275:Injections, Intravenous / Q000662:veterinary; D008297:Male; D012516:Osteosarcoma / Q000150:complications / Q000188:drug therapy / Q000662:veterinary*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000662:veterinary*; D010166:Palliative Care; D000077268:Pamidronate; D010455:Peptides / Q000652:urine; D011446:Prospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D024042:Collagen Type I; D004164:Diphosphonates; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000077268:Pamidronate