Oral Ibandronate in Metastatic Bone Breast Cancer: The Florence University Experience and a Review of the Literature

Abstract

Ibandronate is an amino-bisphosphonate approved in metastatic breast cancer to reduce skeletal complications and to alleviate bone pain. we report our experience about the safety of oral ibandronate and review the literature.We treated 44 patients and administered 524 cycles of oral ibandronate (a single cycle was defined as a 50 mg capsule once daily for 28 days) with a median of 12 cycles (range 6-24). At a median follow-up of 18.5 months (range 6-28) the mean pain score decreased from 1.59 (SD+/-0.97) at baseline to 0.41 (SD+/-0.72) after 48 weeks of treatment. The mean analgesic score was 1.89 (SD+/-1.37) at baseline and 1.46 (SD+/-1.62) after 48 weeks of treatment. Ibandronate was generally well-tolerated; we had no Grade 3-4 adverse events. No patients had deterioration of renal function. No patients developed bisphosphonate-associated osteonecrosis of the jaw. Our experience confirmed that ibandronate may be a useful and safe co-analgesic to conventional treatments for bone pain in selected metastatic breast cancer patients.

Pathogenesis and Bisphosphonate Treatment of Skeletal Events and Bone Pain in Metastatic Cancer: Focus on Ibandronate

“…During postmarketingsurveillanceforupto24weeksofthe712patients reporting pain at baseline, 70% showed improvement after ibandronatetreatment(i.v.andoral)withameanoveralldecreaseinpainscoreof1.6(p<0.0001) [63].Meanpainscores were reduced in 205 patients previously treated with other bis phosphonates (-1.0; p < 0.0001) and in 59 patients with prioribandronatetreatment(-0.5;p=0.0108).Therewasno overall change in performance status in this study. A case series of 44 patients showed similar findings [64]. After a median of 12 28-day cycles of oral ibandronate 50 mg daily, themeanpainscore(5-pointvisualanaloguescale,VAS)decreased from 1.59 to 0.41 (median follow-up 18.5 months).…”

Effects of zoledronic acid and ibandronic acid on renal functions and calcium, phosphorus and alkaline phosphatase levels in breast cancer patients with bone metastases: a retrospective analysis

“…It has also been determined to have similar safety in terms of side-effects [11]. One study of oral ibandronate in 44 patients determined a mean follow-up duration of 18.5 months, with no impairment in renal function [12]. Renal toxicity associated with ibandronic acid was so low as to be equivalent to placebos [4].…”

Preparation, Characterization, and Preliminary Imaging Study of [188Re]Re‐Ibandronate as a Novel Theranostic Radiopharmaceutical for Bone Metastasis

“…Nonetheless, the nephrotoxicity of ibandronic acid is extremely low and equivalent to that of the placebo. Another study [ 17 ] conducted on 44 patients treated with ibandronate (IBA) reported no impairment of renal function during an average follow-up of 18.5 months. In addition, Han et al [ 18 ] noted that the pain relief rate and improvement in the quality of life in patients with bone tumors were higher in the ibandronic acid group than in the zoledronic acid group ( P < 0.05).…”