title: Bisphosphonate use in patients with lung cancer and bone metastases: recommendations of a European expert panel.
abstract: BACKGROUND
  Bisphosphonates (BPs) are effective in preventing, reducing the incidence, and delaying the onset of skeletal-related events in patients with bone metastases in a variety of solid tumors, including lung cancer. The purpose of this article is to review the current evidence for the use of BPs in lung cancer and to provide specific European recommendations to support the clinical practice of using BPs to treat patients with lung cancer with bone metastases.
  
  
  METHODS
  An expert panel of European clinical oncologists and lung cancer specialists convened for two face-to-face meetings designed to review available evidence on the efficacy of BPs in lung cancer and to develop recommendations based on published literature and clinical practice experiences.
  
  
  RESULTS
  The panel recommends screening patients with lung cancer for bone metastases at the initial staging of disease to assess symptomatic bone metastases and screen for asymptomatic bone metastases and to allow accurate monitoring of bone disease progression and initiate bone-specific therapy. Bone assessment should be based on positron emission tomography (if available) or bone scan. BPs should be added to the treatment of patients with lung cancer (with non-small cell lung cancer or small cell lung cancer) who develop bone metastases. In such patients, BPs must be considered part of metastatic lung cancer treatment to prevent and delay the occurrence of further bone metastases and skeletal-related events and to relieve pain where present. BP treatment should continue for as long as it is practically feasible in the absence of any significant adverse effects.
authors.affiliation: Thoracic Oncology Unit I, Chief Carlo Forlanini Hospital, Rome, Italy. demarinis.filippo@virgilio.it
authors.forename: Filippo
authors.initials: F
authors.lastname: De Marinis
authors.forename: Wilfried
authors.initials: W
authors.lastname: Eberhardt
authors.forename: Peter G
authors.initials: PG
authors.lastname: Harper
authors.forename: Bartomeu Massuti
authors.initials: BM
authors.lastname: Sureda
authors.forename: Kristiaan
authors.initials: K
authors.lastname: Nackaerts
authors.forename: Jens Benn
authors.initials: JB
authors.lastname: Soerensen
authors.forename: Kostas
authors.initials: K
authors.lastname: Syrigos
authors.forename: Jean
authors.initials: J
authors.lastname: Trédaniel
mesh_terms: D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D012189:Retrospective Studies
chemical_list: D004164:Diphosphonates