Bisphosphonate Use in Patients with Lung Cancer and Bone Metastases: Recommendations of a European Expert Panel

Marinis, Filippo de; Eberhardt, Wilfried; Harper, Peter; Sureda, B. Massuti; Nackaerts, Kristiaan; Soerensen, Jette Led; Syrigos, Kostas; Trédaniel, Jean

doi:10.1097/jto.0b013e3181b68e5a

Cited by 59 publications

(39 citation statements)

References 71 publications

(72 reference statements)

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“…The use of biphosphonates for delaying or preventing the development of SRE in lung cancer patients with bone metastasis is strongly recommended [33]. In the present study, when zolendronic acid was compared with placebo, in patients receiving zoledronic acid, median time to development of first SRE was prolonged (5.6 vs 5.0 months, respectively), and zoledronic acid delayed the appearance of SRE in patients with NSLCL.…”

Section: Discussionmentioning

confidence: 55%

Risk factors for skeletal-related events (SREs) and factors affecting SRE-free survival for nonsmall cell lung cancer patients with bone metastases

et al. 2015

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Skeletal-related events (SREs) for nonsmall cell lung cancer (NSCLC) patients with bone metastasis lead to serious morbidity. The aim of this study was to determine risk factors for SREs in NSCLC patients with bone metastasis and the factors influencing SRE-free survival and overall survival (OS). From 2000 to 2012, we evaluated retrospectively 835 NSCLC patients. Three hundred and thirty-five of them with bone metastasis were included in the study. SREs and the other prognostic factors were evaluated by univariate and multivariate analysis for SRE-free survival and OS. SREs were detected in 244 patients (72.8 %). The most common SREs were the need for radiotherapy (43.2 %) and malignant hypercalcemia (17.6 %). The median time to first SRE was 3.5 months at the median follow-up of 17 months. A multivariate analysis showed that the presence of bone metastasis at diagnosis (p < 0.001), the number of bone metastasis (p = 0.001), baseline hypercalcemia (p = 0.004), and the presence of palliative radiotherapy (p = 0.04) were independent prognostic factors for SRE-free survival. A logistic regression analysis identified that the presence of bone metastasis at diagnosis [odds ratio (OR), 12.6], number of bone metastasis (OR, 3.05), and baseline hypercalcemia (OR, 0.33) were found to be predictive factors in the developing of SRE. The median OS time for patients with SRE was worse than that for patients without SRE (7 vs 12 months, respectively). For OS, male gender, ECOG performance status (PS), high lactate dehydrogenase (LDH) level, hypoalbuminemia, the presence of bone metastasis at diagnosis, the number of bone metastasis, the presence of SREs, the presence of bisphosphonate therapy, and palliative radiotherapy were independent prognostic indicators for OS by the multivariate analysis. Our results indicated that the frequency of SREs was high and the presence of bone metastasis at the time of diagnosis, baseline hypercalcemia, and multiple bone metastases were significant factors predicting the occurrence of SREs. If bone metastases diagnose earlier, treatments for the prevention of SREs may be initiated earlier; thus, the deterioration of quality of life may be preserved.

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Section: Discussionmentioning

confidence: 55%

Risk factors for skeletal-related events (SREs) and factors affecting SRE-free survival for nonsmall cell lung cancer patients with bone metastases

et al. 2015

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“…The benefit of bisphosphonate treatment in the NSCLC population with bone metastasis is well documented, and bisphosphonate treatment for lung cancer with bone metastasis has been strongly recommended to prevent and delay SREs [4,25]. However, in our study population only a very small proportion of patients (6.6%) received bisphosphonate (pamidronate or zoledronic acid) for primary prevention of SRE.…”

Section: Discussionmentioning

confidence: 91%

Predictors of skeletal-related events in non-small cell lung cancer patients with bone metastases

Sun,

Ahn,

Lee

et al. 2011

Lung Cancer

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“…Many clinical studies in which urinary NTx levels were used as a marker have been reported in the past [13][14][15]; however, we were unable to find examples of studies of serum NTx. In our study, the results clearly indicate that serum NTx levels are more closely related to bone metastasis than to ALP or LDH, which have been said to become elevated during bone metastasis [16,17].…”

Section: Discussionmentioning

confidence: 88%

Usefulness of the serum cross-linked N-telopeptide of type I collagen as a marker of bone metastasis from lung cancer

et al. 2011

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Bone metastasis is an important factor for determining the appropriate treatment for patients with lung cancer. The cross-linked N-terminal telopeptide of type I collagen (NTx) is a metabolite of type I collagen, the main constituent of the bone matrix. Urinary NTx is recognized as a useful marker of bone metastasis, but the application of serum NTx and its cutoff value for determining bone metastasis from lung cancer have not been characterized. We measured serum NTx by enzyme-linked immunosorbent assay of individuals who underwent staging during hospitalization for initial treatment of lung cancer in our department and compared the NTx levels with the presence of bone metastasis in staging. The study included 166 patients with lung cancer (128 men and 38 women), including 85 adenocarcinoma, 42 squamous cell carcinoma, 32 small-cell carcinoma, and 7 other cancer types. Bone metastasis was present in 73 cases. The average/median serum NTx of bone metastasis (+) and bone metastasis (-) was 27.8/23.8 and 17.1/16.5 nmol bone collagen equivalents/L, respectively. There was an intentional difference with P < 0.001. The cutoff value of the serum NTx level indicating bone metastasis from lung cancer was estimated using the receiver operating characteristics curve. The optimal cutoff value was found to be 22.0 (sensitivity: 61.6%, specificity: 89.2%). The results of univariate and multivariate analysis revealed that the serum NTx levels were significantly related to bone metastasis from lung cancer (P < 0.001). Measurement of serum NTx levels provides a simple diagnostic marker of bone metastasis from lung cancer.

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Bisphosphonate Use in Patients with Lung Cancer and Bone Metastases: Recommendations of a European Expert Panel

Cited by 59 publications

References 71 publications

Risk factors for skeletal-related events (SREs) and factors affecting SRE-free survival for nonsmall cell lung cancer patients with bone metastases

Risk factors for skeletal-related events (SREs) and factors affecting SRE-free survival for nonsmall cell lung cancer patients with bone metastases

Predictors of skeletal-related events in non-small cell lung cancer patients with bone metastases

Usefulness of the serum cross-linked N-telopeptide of type I collagen as a marker of bone metastasis from lung cancer

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