Ibandronate in the treatment of prostate cancer associated painful osseous metastases

Heidenreich, Axel; Elert, A.; Hofmann, Rainer

doi:10.1038/sj.pcan.4500574

Cited by 94 publications

(57 citation statements)

References 27 publications

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“…ibandronate therapy for 20 weeks (6 mg every 3-4 weeks). In the prostate cancer trial, 92% of patients experienced significantly reduced pain scores (p Ͻ .001) [34]. Similarly, in the urologic cancer trial, 83% of patients experienced pain relief, with 25% of patients becoming pain-free.…”

Section: Bone Painmentioning

confidence: 90%

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The Use of Bisphosphonates in Elderly Cancer Patients

Gridelli

2007

The Oncologist

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the role of bisphosphonate therapy in the management of metastatic bone disease.2. Describe the differences between individual bisphosphonates with regard to safety and route of administration.3. List the reasons for including elderly patients in clinical trials of bisphosphonates for the management of metastatic bone disease.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTAs life expectancy increases throughout the 21st century, the size of the elderly population will also expand. This will have a marked effect on the number of patients with cancer who are classified as elderly. Despite this, the design of most clinical studies of cancer therapies excludes those patients who are >70 years of age.Bisphosphonates are an example of a cancer therapy that has not been examined in randomized clinical trials of elderly patients. These agents are used for the prevention of skeletal complications and the relief of bone pain in patients with bone metastases. When deciding which bisphosphonate to prescribe to an elderly patient, each drug should be considered on its individual merits. Examples of areas of concern with bisphosphonates in elderly patients include their relative renal safety profiles and propensity for osteonecrosis of the jaw. Another consideration when choosing the most appropriate formulation is the preferred method of administration (oral or i.v.), which may affect patient compliance with therapy.As the use of bisphosphonates increases, the need for data on their use in elderly patients also becomes greater. Clinical trials of bisphosphonates in this patient population are currently under way, and their results are keenly awaited. The Oncologist 2007;12:62-71

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Section: Bone Painmentioning

confidence: 90%

“…A number of small phase II studies suggest that intensive dosing schedules of ibandronate may achieve rapid pain relief within 3 days in patients with moderate-to-severe bone pain [33][34][35][36]. Two of the trials reported by Heidenreich et al have assessed the effects of i.v.…”

Section: Bone Painmentioning

confidence: 99%

The Use of Bisphosphonates in Elderly Cancer Patients

Gridelli

2007

The Oncologist

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“…Mean bone-pain scores remained below baseline for 20 weeks and were accompanied by improved patient functioning. In a separate study of 45 patients with hormone-refractory prostate cancer, ibandronate significantly relieved pain in 89% of patients by day 3 of treatment (p < .001) [37,38]. Pain relief was accompanied by a 50% reduction in daily analgesic requirement in 20 of 45 patients and a significant improvement in performance status (p = .01).…”

Section: Studies Of Intensive Ibandronate Dosingmentioning

confidence: 99%

Efficacy of Ibandronate in Metastatic Bone Disease: Review of Clinical Data

Bell

2005

The Oncologist

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Bone involvement is a significant complication of metastatic cancer that occurs in up to 95% of multiple myeloma patients, up to 75% of breast and prostate cancer patients, and 15%-40% of patients with primary lung, colon, or kidney tumors [1,2]. Bone metastases cause considerable morbidity, including severe pain, immobility and disability, pathologic fractures, life-threatening hypercalcemia, and spinal cord compression. These problems have a major impact on patient quality of life. The spread of tumor cells to bone normally signifies that the cancer is incurable with, for example, only 20% of breast cancer patients alive at 5 years after the initial diagnosis [1]. The primary treatment goal for metastatic bone disease is therefore to alleviate symptoms and enable patients to continue with a normal life for as long as possible.Bisphosphonates are the standard of care for treating metastatic bone disease. These agents inhibit the function of osteoclasts, which are bone-resorbing cells essential for bone remodeling [3]. The presence of tumor metastasis in bone tissue results in excessive osteoclast activity with consequent destruction of bone architecture and loss of structural integrity. Bisphosphonates have the potential to prevent bone complications, and current recommendations suggest that all

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“…Interestingly, ibandronate appears to have minimal to no renal toxicity, even in patients with underlying CKD (62)(63)(64). However, more experience with this drug for the treatment of malignancy-associated hypercalcemia is needed before firm conclusions on its renal safety can be made.…”

Section: Bisphosphonatesmentioning

confidence: 99%

Onco-Nephrology

Rosner

Dalkin

2012

Clinical Journal of the American Society of Nephrology

134

108

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SummaryHypercalcemia complicates the course of 10%-30% of all patients with malignancies and can be a sign of very poor prognosis and advanced malignancy. Prompt recognition of the nonspecific signs and symptoms of hypercalcemia and institution of therapy can be lifesaving, affording the opportunity to address the underlying etiology. The mechanisms of malignancy-associated hypercalcemia generally fall into three categories: humoral hypercalcemia due to secreted factors (such as parathyroid-related hormone), local osteolysis due to tumor invasion of bone, and absorptive hypercalcemia due to excess vitamin D produced by malignancies. The mainstays of therapy for hypercalcemia are aggressive intravenous volume expansion with saline, bisphosphonate therapy, and perhaps loop diuretics. Adjunctive therapy may include calcitonin and corticosteroids. In refractory cases, gallium nitrate and perhaps denosumab are alternatives. In patients presenting with severe AKI, hemodialysis with a low-calcium bath can be effective. In most cases, therapy normalizes calcium levels and allows for palliation or curative therapy of the malignancy.

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Ibandronate in the treatment of prostate cancer associated painful osseous metastases

Cited by 94 publications

References 27 publications

The Use of Bisphosphonates in Elderly Cancer Patients

The Use of Bisphosphonates in Elderly Cancer Patients

Efficacy of Ibandronate in Metastatic Bone Disease: Review of Clinical Data

Onco-Nephrology

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