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

Francini, Filippo; Pascucci, Alessandra; Bargagli, Gianluca; Francini, Edoardo; Conca, Raffaele; Miano, Salvatora Tindara; Martellucci, Ignazio; Migali, Cristina; Gotti, Giuseppe; Fiaschi, Anna Ida; Cozzolino, A; Petrioli, Roberto

doi:10.1007/s10147-010-0179-x

Cited by 19 publications

(51 citation statements)

References 37 publications

(36 reference statements)

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“…Currently, no comparative studies of bisphosphonates have been undertaken in prostate cancer, and ibandronate, pamidronate, and clodronate have not been directly compared in any malignancy. Indirect evidence suggests that zoledronic acid and ibandronate might be similarly active at reducing bone turnover markers in patients with breast and nonsmall cell lung cancer (18,19), whereas preclinical studies indicate that zoledronic acid is more than 16,000 times more potent than clodronate, 850 times more potent than pamidronate, and 20 times more potent than ibandronate (20).…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Bisphosphonates in Metastatic Breast and Prostate Cancer and Multiple Myeloma: A Mixed-Treatment Meta-analysis

Palmieri

Fullarton

Brown

2013

Clinical Cancer Research

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Purpose: A mixed-treatment comparison (MTC) was undertaken to compare the efficacy of zoledronic acid, clodronate, pamidronate, and ibandronate (i.v. and oral) in patients with skeletal-related events (SRE) secondary to metastatic breast and prostate cancer and multiple myeloma.Experimental Design: Studies of bisphosphonates in the three malignancies were identified and SRE data were extracted. Outcomes from the MTC were expressed as the annual SRE rate and as the mean likelihood (probability) ratio for the rate of SREs during treatment with zoledronic acid compared with the other bisphosphonates.Results: A total of 17 studies were identified (7 breast, 3 prostate, and 7 multiple myeloma). Data were available for all bisphosphonates in breast cancer; no data were available for ibandronate (oral or i.v.) in prostate cancer or for oral ibandronate in multiple myeloma. The SRE rates in breast cancer were 1.60 for zoledronic acid, 1.67 for oral ibandronate (excess SRE rate, 4%), 1.70 for i.v. ibandronate (6%), 2.07 for pamidronate (29%), and 2.29 for clodronate (42%). In prostate cancer, the SRE rates were 0.83 for zoledronic acid, 1.11 for clodronate (35%), and 1.41 for pamidronate (71%). In multiple myeloma, the SRE rates were 1.43 for zoledronic acid, 1.64 for pamidronate (15%), 1.90 for clodronate (33%), and 2.49 for i.v. ibandronate (75%).Conclusions: Zoledronic acid seems to be the most efficacious bisphosphonate for reducing the risk of SREs in patients with cancer of the breast or prostate and those with multiple myeloma.

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Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Bisphosphonates in Metastatic Breast and Prostate Cancer and Multiple Myeloma: A Mixed-Treatment Meta-analysis

Palmieri

Fullarton

Brown

2013

Clinical Cancer Research

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“…At 3 months, s-CTX was reduced by 72.6% and 66.4% (p = 0.22), respectively. BALP levels were decreased similarly by both BPs at 1 month (ZOL 24.7%, and ibandronate 24.2%) and at 3 months (ZOL 28.6%, and ibandronate 24.2%) reporting an overall comparable efficacy [84].…”

Section: Biomarkersmentioning

confidence: 48%

Bone Metastases and Non-Small Cell Lung Cancer: From Bisphosfonates to Targeted Therapy

Rossi

Gridelli

Ricciardi

et al. 2012

CMC

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About 30-40% of patients affected by non-small cell lung cancer (NSCLC) develop, during the course of their disease, bone metastases. The prognosis of these patients is poor with a median survival of less than 1 year. The therapeutic approach includes: palliative radiotherapy, and systemic therapy. In clinical practice, zoledronate is the most commonly used bisphosphonate to prevent, reduce the incidence and delay the onset of skeletal-related events in patients with metastatic NSCLC. However, an Italian Association of Thoracic Oncology (AIOT) survey, conducted to evaluate how bisphosphonates were used in clinical practice for the treatment of lung cancer bone metastases in Italy, showed that the bisphosphonates treatment is still not routine and varies in duration. Denosumab is a fully human monoclonal antibody directed against the receptor activator of nuclear factor kappa-B (RANK)-Ligand inhibiting the maturation of pre-osteoclasts into osteoclasts and is the first example of targeted therapy for bone metastases. An exploratory analysis showed that denosumab was associated with improved overall survival compared with zoledronate in patients with bone metastases from lung cancer. Biochemical markers of bone turnover to predict what patients are at greatest risk of developing skeletal-related events, and to direct treatment of bone metastases with either bisphosphonates or denosumab, are under investigation. This review is focused on the systemic management of bone metastases from NSCLC.

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“…Twelve studies (17 publications) met the inclusion criteria, including a total of 1,767 participants (Figure 1) [6, 7, 18, 25-39]. Of these, only seven studies reported sufficient data for the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…None of the studies described the method of randomization (e.g., random number table) or allocation concealment (e.g., sealed envelopes). Only three trials described baseline similarity among the groups [25, 27, 36]. Blinding was often not feasible, especially when non-drug treatment modalities (e.g., radiation therapy) were included.…”

Section: Resultsmentioning

confidence: 99%

“…Because all treatments were multi-modal, none of the trials could avoid co-interventions. Although none of the trials mentioned patient adherence to treatment, 2 trials described patient drop-out owing to side effects or other adverse events such as renal impairment, gastrointestinal problems, or osteonecrosis of the jaw [25, 31]. Overall, seven trials included all randomized or assigned patients in the final analysis, thus providing intention-to-treat analysis [27-32, 37-39].…”

Section: Resultsmentioning

confidence: 99%

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Bisphosphonates in the treatment of patients with lung cancer and metastatic bone disease: a systematic review and meta-analysis

López-Olivo

Shah

Pratt

et al. 2012

Support Care Cancer

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Purpose Bisphosphonates are known to prevent skeletal-related events (SREs) in advanced breast cancer, prostate cancer and multiple myeloma. This systematic review assessed the efficacy of bisphosphonates in preventing SREs, controlling pain, and overall survival in patients with bone metastases from lung cancer. Methods We searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library databases through November 10, 2011, for controlled trials that included lung cancer patients with bone metastases treated with bisphosphonates. Two reviewers independently extracted data on pain control, survival, SREs and evaluated the quality of each study. Meta-analyses were performed when there were two or more trials with similar outcomes. Results Twelve trials, met our inclusion criteria, and included 1,767 patients. Studies were placebo-controlled or compared bisphosphonates with other modalities (chemotherapy, radiation therapy, or radioisotope therapy), or used different bisphosphonates as active controls. Randomized controlled trials did not report adequate descriptions of randomization procedures, allocation concealment, and blinding, resulting in low quality scores. Patients treated with zoledronic acid + chemotherapy had fewer SREs than those receiving chemotherapy alone (relative risk (RR) 0.81, 95% confidence interval (CI) 0.67-0.97). Pain control improved when a bisphosphonate was added to another treatment modality (chemotherapy or radiation; RR 1.18, 95%CI 1.0-1.4). Bisphosphonate therapy improved survival compared to controls, but the difference failed to reach statistical significance (mean of 72 days, 95%CI −8.9-152.9). Conclusions Treatment with bisphosphonates reduced SREs, improved pain control and showed a trend to increased survival. Bisphosphonates should be used in the treatment of patients with lung cancer and bone metastases.

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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

Abstract: Considering the changes in bone markers, ZOL and oral IBA show comparable efficacy in patients with NSCLC and bone metastases.

Cited by 19 publications

References 37 publications

Comparative Efficacy of Bisphosphonates in Metastatic Breast and Prostate Cancer and Multiple Myeloma: A Mixed-Treatment Meta-analysis

Comparative Efficacy of Bisphosphonates in Metastatic Breast and Prostate Cancer and Multiple Myeloma: A Mixed-Treatment Meta-analysis

Bone Metastases and Non-Small Cell Lung Cancer: From Bisphosfonates to Targeted Therapy

Bisphosphonates in the treatment of patients with lung cancer and metastatic bone disease: a systematic review and meta-analysis

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