Metastatic bone pain palliation with 89‐Sr and 186‐Re‐HEDP in breast cancer patients

Sciuto, Rosa; Festa, Anna; Pasqualoni, Rosella; Semprebene, A.; Rea, Sandra; Bergomi, Serenella; Maini, C.L.

doi:10.1023/a:1010658522847

Cited by 97 publications

(50 citation statements)

References 18 publications

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“…Moreover, even though no apparent outcome is available in prostate cancer patients with bone metastasis resistant to hormonal treatment, at a few randomized controlled trials containing minor figures of radioisotope treatment, it has been demonstrated to relieve pain in breast and lung cancer patients with bone metastasis (Sciuto et al, 2001;Han et al, 2002;Leondi et al, 2004).…”

Section: Roles Of Radiotherapy Radioisotopes and Bisphosphonatesmentioning

confidence: 99%

Cancer Pain Prevalence and its Management

Arslan¹,

Koca²,

Akar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Pain is a public health problem affecting more than half of cancer patients. Despite the success of the protocols currently used, pain cannot still be reduced satisfactorily in the large majority of patients. In order to improve pain management, all healthcare professionals involved with pain should have sufficient knowledge on pain assessment and treatment, and should inform patients to prevent patient-related barriers. In this compilation, the prevalence values and the treatment methods of cancer pain, and the barriers to pain management have been assessed.

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Section: Roles Of Radiotherapy Radioisotopes and Bisphosphonatesmentioning

confidence: 99%

Cancer Pain Prevalence and its Management

Arslan¹,

Koca²,

Akar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…We have chosen to study the effects of etoposide and cisplatin, as both have been in clinical trials for prostate cancer treatment (Sciuto et al, 2002;Steineck et al, 2002;Hoshi et al, 2003;Vaishampayan et al, 2004). Etoposide exerts its function through blocking topoisomerase II in the religation step, which results in single-and double-stranded DNA breaks (Hande, 1998).…”

Section: Introductionmentioning

confidence: 99%

Androgen receptor activity is inhibited in response to genotoxic agents in a p53-independent manner

2006

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The androgen receptor (AR) is fundamental to androgen signalling within the prostate gland, and deregulation of its activity is frequently linked to the development of prostate cancer. Advanced prostate cancer is often treated with chemotherapy and most of these drugs exert their function by generating genotoxic stress such as DNA damage. We have investigated here the effects of genotoxic agents used in chemotherapeutic regimens on AR function and expression. We have discovered that endogenous AR activity in LNCaP cells is inhibited in response to the chemotherapeutic agents etoposide and cisplatin. This loss of AR activity is not caused by a change in cell cycle distribution, a change in subcellular localisation of the AR nor by induction of apoptosis. In addition, we found that inhibition of AR activity in response to genotoxic stress is independent of p53 function. Interestingly, our studies revealed that genotoxic stress inhibits the hormone-stimulated recruitment of AR to androgen response elements. Thus, we report for the first time a mechanism by which the AR activity is inhibited in response to different chemotherapeutic agents.

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“…Flare reactions can be managed by analgesics or steroid agents (30). An incidence of 10%-30% has been reported with 186 Re-HEDP (13,(31)(32)(33)(34) and up to 50% with 188 Re (19). In our study, flare reactions occurred in 63% of patients and could have been due to the patients' awareness of the probable short-term worsening of bone pain, higher administered dose, or greater fluctuations in the level of pain.…”

Section: Discussionmentioning

confidence: 54%

Phase 2 Study of a High Dose of 186Re-HEDP for Bone Pain Palliation in Patients with Widespread Skeletal Metastases

Pirayesh

Amoui

Mirzaee

et al. 2013

Journal of Nuclear Medicine Technology

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186 Re-1-hydroxyethylidene-1,1-diphosphonate (HEDP) is an attractive radiopharmaceutical for the treatment of bone pain arising from skeletal metastatic lesions. Currently, 186 Re-HEDP is most commonly used in European countries. The aim of this study was to investigate the palliative efficacy and adverse effects of 186 Re-HEDP in patients with different types of cancers and skeletal bone pain. Methods: Nineteen (8 male, 11 female) patients with various cancers (breast, prostate, renal cell carcinoma, colon, and neuroendocrine tumors) and painful bone metastases were included in the study. A dose of 1,480-3,330 MBq (40-90 mCi) of 186 Re-HEDP was administered intravenously. The patients' level of pain relief was assessed by the Visual Analog Scale for 8 wk after treatment and by a weekly blood cell count to evaluate for hematologic toxicity. Results: The overall response rate was 89.5%, and the mean pain score assessed by the Visual Analog Scale was reduced from 9.1 to 5.3 after 1 wk (P 5 0.003). No adverse effects were reported by patients during intravenous administration or for up to 24 h after administration. A flare reaction was seen in 63.2% of patients, mainly during days 1-3, and lasted for 2-4 d. There was no significant correlation between the response to therapy and the flare reactions (P . 0.05). The nadir of platelet reduction occurred at the fourth or fifth week and led to platelet infusion in only 4 patients with a low baseline platelet count and diffuse skeletal metastases. Bone marrow suppression occurred in patients receiving higher doses, but no clinical problems were seen except in 2 patients who required packed cell transfusion similar to their prior transfusions. Conclusion: 186 Re-HEDP is an effective radiopharmaceutical for the palliative treatment of metastatic bone pain and has minimal adverse effects.Key Words: rhenium 186(tin) etidronate; pain palliation; bone metastasis Nucl Med Technol 2013; 41:192-196 DOI: 10.2967/jnmt.113.124297 The skeleton is the most common site of metastatic disease, and tumors arising from the breast, prostate, lung, thyroid, and kidney commonly spread to bone. The frequency of bone metastases has been estimated at 65%-75% in patients with breast and prostate cancer (1,2) and about 30%-40% in those with lung cancer (3). Bone pain, as the main symptom of skeletal metastases and the most common type of cancer-related pain, obviously has a negative impact on quality of life (4). Currently, the factors contributing to cancer pain are not completely understood (5,6), and metastatic bone pain might be poorly localized for external radiation therapy (7). Various modalities have been introduced for the treatment of bone metastases, including analgesics, hormone therapy, cytotoxic drugs, biphosphonates, and surgery; however, they are not effective in all patients with painful refractory skeletal metastases. An alternative approach is systemic administration of radiopharmaceuticals, which is a valuable and effective method for relieving bone pain in patients with ...

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Metastatic bone pain palliation with 89‐Sr and 186‐Re‐HEDP in breast cancer patients

Abstract: Both 89Sr and 186Re-HEDP are effective and safe in bone pain palliation in breast cancer with the latter showing a significantly faster onset of pain relief.

Cited by 97 publications

References 18 publications

Cancer Pain Prevalence and its Management

Cancer Pain Prevalence and its Management

Androgen receptor activity is inhibited in response to genotoxic agents in a p53-independent manner

Phase 2 Study of a High Dose of 186Re-HEDP for Bone Pain Palliation in Patients with Widespread Skeletal Metastases

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