Effects of intravenous zoledronic acid and oral ibandronate on early changes in markers of bone turnover in patients with bone metastases from non-small cell lung cancer.
BACKGROUND
The aim of this study was to assess the early effects of zoledronic acid (ZOL) and oral ibandronate (IBA) on the bone resorption marker s-CTX (serum C-telopeptide of collagen type I) and the bone formation marker B-ALP (bone-alkaline phosphatase) in patients with bone metastases from non-small cell lung cancer (NSCLC).


METHODS
Fifty-five patients with at least one site of bone metastasis secondary to NSCLC were randomly assigned to receive intravenous ZOL 4 mg every 4 weeks, or oral IBA 50 mg/day.


RESULTS
At 1 month of treatment, s-CTX was reduced by 54.8% (95% CI 40.4-59.8%) in the ZOL group (26 evaluable patients) compared with 38.2% (95% CI 29.8-48.7%) in the oral IBA group (27 evaluable patients) (p = 0.03). At 3 months, s-CTX was reduced by 72.6% (95% CI 58.6-71.3%) in the ZOL group, compared with 66.4% (95% CI 54.3-79.5%) in the oral IBA group (p = 0.22). Both bisphosphonates similarly decreased the bone marker B-ALP at 1 month (ZOL 24.7%, 95% CI 3.6-39.5%, and IBA 24.2%, 95% CI 2.8-43.4%) and 3 months (ZOL 28.6%, 95% CI +2.8-43.3%, and IBA 24.2%, 95% CI 3.2-47.4%). Both bisphosphonates were well tolerated.


CONCLUSIONS
Considering the changes in bone markers, ZOL and oral IBA show comparable efficacy in patients with NSCLC and bone metastases.
Department of Odontostomatology and Maxillo-Facial Surgery, University of Siena, Siena, Italy.
Filippo
F
Francini
Alessandra
A
Pascucci
Gianluca
G
Bargagli
Edoardo
E
Francini
Raffaele
R
Conca
Salvatora Tindara
ST
Miano
Ignazio
I
Martellucci
Cristina
C
Migali
Giuseppe
G
Gotti
Anna Ida
AI
Fiaschi
Annunziata
A
Cozzolino
Roberto
R
Petrioli
D000284:Administration, Oral; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000556:secondary*; D016723:Bone Remodeling / Q000187:drug effects; D001862:Bone Resorption / Q000139:chemically induced; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000473:pathology / Q000556:secondary*; D024042:Collagen Type I / Q000378:metabolism*; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D000077557:Ibandronic Acid; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects; D007275:Injections, Intravenous; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000378:metabolism*; D016896:Treatment Outcome; D000077211:Zoledronic Acid
D014408:Biomarkers, Tumor; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000077211:Zoledronic Acid; C548267:ALPL protein, human; D000469:Alkaline Phosphatase; D000077557:Ibandronic Acid
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