Under usage of zoledronic acid in non-small cell lung cancer patients with metastatic bone disease – a short communication

Calderone, Rosa Gioia; Nimako, Kofi; Leary, Alexandra; Popat, Sanjay; O’Brien, Mary

doi:10.1016/j.ejca.2011.05.008

Cited by 12 publications

(10 citation statements)

References 7 publications

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“…A study focusing on patients with lung cancer reported that as few as 38% of the patients received the bisphosphonate zoledronic acid, which was the most commonly used bone-targeted agent at the time (28). A prospective chart audit investigating bisphosphonate use in individuals with lung cancer revealed that 44% of the patients were not receiving treatment at the time of the study (29).…”

Section: Discussionmentioning

confidence: 99%

Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study

Lorusso¹,

Durán

Garzón-Rodríguez

et al. 2014

Molecular and Clinical Oncology

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Abstract. Bone complications or skeletal-related events (SREs), typically defined as radiation to bone, pathological fractures, surgery to bone and spinal cord compression, occur frequently in patients with bone metastases. As the survival of patients with advanced lung cancer improves, preventing SREs is becoming increasingly clinically relevant. The aim of this analysis was to assess the impact of SREs on health resource utilisation (HRU) in European lung cancer patients with bone metastasis. This multinational, observational study included patients who had at least one SRE in the 97 days prior to enrolment, a life expectancy of ≥6 months and an Eastern Cooperative Oncology Group performance status of 0-2. Data on HRU were retrospectively collected for up to 97 days prior to enrolment with a planned prospective follow-up for up to 18-21 months. The HRU measures included the number and length of inpatient hospitalisations and the number of outpatient visits and procedures. The investigators determined whether each HRU was attributable to a SRE. In total, 135 patients with lung cancer, enrolled at centres in Germany, Italy, Spain and the United Kingdom, contributed 214 SREs to this analysis. The median length [quartile (Q)1, Q3] of follow-up ranged from 1.5 (0.7, 3.3) to 5.6 (2.0, 8.2) months across the countries. Overall, 41% of the SREs required an inpatient stay, with a median (Q1, Q3) duration of 19.0 (6.0, 28.0) days. Spinal cord compression and surgery to bone were the SRE types most frequently requiring inpatient stays. Radiation to bone was associated with the largest number of outpatient visits and procedures. All the SREs resulting from bone metastases in patients with lung cancer contribute considerably to HRU and efforts to minimise the incidence of bone complications in these patients through appropriate treatments may help reduce this burden.

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Section: Discussionmentioning

confidence: 99%

Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study

Lorusso¹,

Durán

Garzón-Rodríguez

et al. 2014

Molecular and Clinical Oncology

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“…Recently, zoledronic acid, in combination with chemotherapy, has been associated with prolonged survival in several cancers [12,27]. Pan et al [11] reported that zoledronic acid treatment combined with docetaxel-based chemotherapy could have better bone pain control and improved OS of prostate cancer patients.…”

Section: Discussionmentioning

confidence: 99%

The Association between Fever and Prognosis in Lung Cancer Patients with Bone Metastases Receiving Zoledronic Acid

Sunaga

Shimamoto²,

Nakamura³

et al. 2017

Chemotherapy

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Zoledronic acid is an established agent used in the management of metastatic bone disease. The administration of zoledronic acid improves overall survival (OS) of lung cancer patients with bone metastases receiving chemotherapy. However, it is currently unknown whether zoledronic acid-induced fever is associated with OS. The purpose of this study was to examine the association between zoledronic acid-induced fever and prognosis in lung cancer patients with bone metastases. We retrospectively analyzed 98 lung cancer patients with bone metastases who had received zoledronic acid. The end point outcome measure was OS. Multivariate analyses were used to estimate the hazard ratio (HR) for OS due to fever after adjusting for covariates. In multivariate analysis, white blood cell (WBC) count, lactate dehydrogenase (LDH) level, fever, chemotherapy, and hypercalcemia were independent prognostic factors, with HRs of 2.834 for WBC count (<10 × 10³/μL vs. ≥10 × 10³/μL, p < 0.001), 3.044 for LDH level (<250 vs. ≥250 IU/L, p < 0.001), 0.603 for fever (<37.0 vs. ≥37.0°C, p = 0.039), 0.481 for chemotherapy (chemotherapy not administered vs. administered, p = 0.006), and 2.453 for hypercalcemia (<11.0 vs. ≥11.0 mg/dL, p = 0.001). Zoledronic acid-induced fever was the most important prognostic factor in this cohort of lung cancer patients with bone metastases.

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“…Forty-three patients received ZOL and chemotherapy and 71 chemotherapy only. Patients who received also ZOL had a median OS of 34 weeks, compared to 19 weeks of patients receiving only chemotherapy (HR 0.60, 95% CI 0.38-0.96; p = 0.03) [55]. Eighteen patients with NSCLC and bone metastasis received carboplatin/nedaplatin plus paclitaxel combined with ZOL.…”

Section: Zoledronatementioning

confidence: 98%

“…Several reports suggest that these side effects are considered responsible of the infrequent use of BPs in treatment regimens for NSCLC [55,57]. In fact, considering the additional potential for cisplatin-induced renal toxicity associated with first-line chemotherapy, careful monitoring of renal function is required before and during treatment with ZOL in patients with NSCLC.…”

Section: Bisphosphonates Side Effectsmentioning

confidence: 99%

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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Under usage of zoledronic acid in non-small cell lung cancer patients with metastatic bone disease – a short communication

Cited by 12 publications

References 7 publications

Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study

Health resource utilisation associated with skeletal-related events in European patients with lung cancer: Α subgroup analysis from a prospective multinational study

The Association between Fever and Prognosis in Lung Cancer Patients with Bone Metastases Receiving Zoledronic Acid

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

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