Differential effect of zoledronic acid on normal trabecular and cortical bone density in oncologic patients with bone metastases

Abstract

PurposeTo evaluate bone density changes at the level of normal bone and bone metastases after zoledronic acid (ZA) treatment in oncologic patients.Materials and methodsWe retrospectively evaluated 72 consecutive adult patients with histologically confirmed solid tumors with at least 1 newly diagnosed bone metastatic lesion. Bone metastases were diagnosed by bone scans and confirmed with computed tomography (CT). Patients received intravenous ZA, 4 mg, by 15-min infusion every 28 day through a peripheral or a central venous access and were monitored for at least 3 months and a maximum of 24 months. Bone density was determined at the level of bone metastases and at the level of normal trabecular and cortical bone using a ROI-based approach.ResultsA significant increase was demonstrated at the level of normal trabecular bone of the calvarium and the femoral neck. No significant increase of density was observed at the level of the normal cortical bone. Bone metastases showed a significant increase in CT density as compared to baseline up to 24 months after zoledronic acid.ConclusionWe have found that long term treatment with ZA increases trabecular bone density in oncologic patients whereas normal cortical bone changes are not detectable.

Tumor-Induced Osteoclast miRNA Changes as Regulators and Biomarkers of Osteolytic Bone Metastasis

“…These effects were seen most clearly in the trabecular region of the femur and tibia, while no significant difference was seen in cortical bone thickness. This finding is similar to the observation in animals treated with bisphosphonates (Quattrocchi et al, 2012), possibly because of the higher rates of turnover in the trabecular bone. Consistently, treatment of mice with the pre-miR-141 and -219 was capable of inhibiting osteolytic bone metastasis.…”

Unwrapping microcomputed tomographic images for measuring cortical osteolytic lesions in the 5T2 murine model of myeloma treated by bisphosphonate

“…Both BPs were active in preventing hypercalcemia, pain and the skeletal related events without making a clear distinction between vertebral fractures (vertebral bodies being mainly composed of trabecular bone) and long bone fractures (mainly composed of cortical bone) (Kanis and McCloskey, 2000). In a study comparing cortical and trabecular bone in oncologic patients with metastasis and treated with Zol, no increase in bone density of cortical bone (measured by volumetric computed tomography density) was noted in the non-invaded bone (Quattrocchi et al, 2012). However, osteolytic metastases containing both trabecular and cortical bone had an increased bone density.…”