Clinical benefits and considerations of bisphosphonate treatment in metastatic bone disease.
Patients with metastatic bone disease are at risk for developing skeletal-related events that can negatively influence quality of life, contributing to loss of autonomy and functional capabilities. Bisphosphonates have become an important component in the treatment of patients with bone metastases as they delay the onset and reduce the risk of skeletal-related events and also palliate or control bone pain in multiple cancer types, thus preserving quality of life. Zoledronic acid has proven efficacy and safety in patients with bone lesions from breast cancer, prostate cancer, lung cancer, and other solid tumors, as well as in patients with multiple myeloma. Current data suggest that early treatment with zoledronic acid (before the onset of bone pain) may provide additional clinical benefits and also positive effects on survival in subsets of patients who have elevated levels of N-telopeptide of type I collagen (NTX), a biochemical marker of bone resorption. Studies have shown that in patients with breast cancer, prostate cancer, lung cancer, or other solid tumors, normalization of elevated levels of NTX was observed in the majority of patients who received zoledronic acid. Furthermore, normalization of NTX values correlated with extended survival.
Saad
Fred
F
Department of Surgical Oncology, Centre Hospitalier de l'Université de Montréal/Hôpital Notre-Dame, Montréal, Quebec, Canada. fred.saad@umontreal.ca
Lipton
Allan
A
D014408:Biomarkers, Tumor / Q000032:analysis; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001847:Bone Diseases / Q000517:prevention & control*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D011788:Quality of Life; D015996:Survival Rate
D014408:Biomarkers, Tumor; D050071:Bone Density Conservation Agents; D004164:Diphosphonates