A randomised double-blind comparison of intravenous pamidronate and clodronate in the hypercalcaemia of malignancy

Abstract

The median time to achieve normocalcaemia was 4 days (range 2-14) for pamidronate and 3 days (range 2-6) with clodronate. The median duration of normnocalcaemia was 28 days (range 10-28 + days) after pamidronate and 14 days after clodronate (range 7-21 days) (P<0.01). Two patients who failed to respond to clodronate were successfully treated with pamidronate and achieved normocalcaemia for 14 and >28 days respectively. Two patients experienced fever after pamidronate but no significant toxicity was observed with either treatment. We conclude that both agents are effective in the management of hypercalcaemia of malignancy. At the doses studied. the effects of pamidronate are more complete and longer lasting than those of clodronate.

Targeting of Tumor Cells for Human γδ T Cells by Nonpeptide Antigens

“…However, our unpublished results indicate that the macrophages can hardly stimulate the preactivated ␥␦ T cells such as ␥␦ T cell lines and clones used in the present study (Y. Tanaka and N. Minato, unpublished observation). These results coincide with the reported clinical observations in human that, while the first administration of pamidronate induces adverse effects such as fever attributable to the massive release of IFN-␥, subsequent repetitive administration is well tolerated with little adverse effects (33)(34)(35)(36)(37)(38)(39). In contrast, our previous (20) and present results have indicated that certain tumor cells are capable of presenting the nonpeptide Ags to both the primary and preactivated ␥␦ T cells quite efficiently.…”

The Use of Zoledronic Acid, a Novel, Highly Potent Bisphosphonate, for the Treatment of Hypercalcemia of Malignancy

“…The response rate to pamidronate disodium (90 mg) in these trials was 69.7%, lower than the response rates observed in previous trials [16]. In the earlier trials, pamidronate disodium (90 mg) normalized CSC levels in most patients (up to 100%) [42,55,63]. Changes in cancer treatment regimens and the restrictions on patient selection since the early trials and differences in study design may have contributed to this difference.…”

“…Comparative studies in patients with HCM suggest that pamidronate disodium is superior to etidronate [53] and clodronate [42]. In the clodronate study, the median duration of normocalcemia following pamidronate treatment was twice as long as the duration achieved for clodronate (28 days versus 14 days, respectively; p < 0.01).…”

“…However, the 1,500 mg clodronate i.v. dose was associated with increased serum creatinine in 5 of 21 (24%) patients in a comparative study with pamidronate [42]. Furthermore, i.v.…”

Onco-Nephrology

“…Randomized clinical trials with pamidronate, zoledronate, and ibandronate have all shown efficacy in the treatment of hypercalcemia of malignancy (42)(43)(44). However, the three bisphosphonates differ in terms of their potency and risk for toxicity.…”