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Toward new horizons: the future of bisphosphonate therapy.
Oncologist. 2004; 9 Suppl 4:38-47.O

Abstract

Bisphosphonate therapy has become a standard of care for patients with malignant bone disease. In addition, preclinical and preliminary clinical data suggest that bisphosphonates may prevent cancer-treatment-induced bone loss (CTIBL) and the development of malignant bone disease in patients with early-stage cancer. Patients who receive adjuvant hormonal therapy for breast cancer or androgen-deprivation therapy for prostate cancer are at an especially high risk for CTIBL because of reduced estrogenic signaling. Oral clodronate (Bonefos; Anthra Pharmaceuticals; Princeton, NJ), oral risedronate (Actonel; Proctor and Gamble Pharmaceuticals, Inc.; Cincinnati, OH), and i.v. zoledronic acid (Zometa; Novartis Pharmaceuticals Corp.; East Hanover, NJ) have all demonstrated promise in preventing CTIBL in patients receiving hormonal therapy for breast cancer. Zoledronic acid has demonstrated efficacy with the longest between-treatment interval (3-6 months) and is currently being investigated in the Zometa/Femara Adjuvant Synergy Trials (Z-FAST and ZO-FAST in the United States and Europe, respectively). In patients receiving androgen-deprivation therapy for prostate cancer, i.v. pamidronate (Aredia; Novartis Pharmaceuticals Corp.) and i.v. zoledronic acid both have demonstrated significant benefits over placebo, but only zoledronic acid produced significant increases in bone mineral density compared with baseline values. Additionally, bisphosphonates have demonstrated antitumor activities in preclinical models, and clinical trials with oral clodronate suggest that bisphosphonates might prevent or delay bone metastasis in patients with early-stage breast cancer. Clinical trials are investigating the effect of zoledronic acid on disease progression in patients with breast cancer, prostate cancer, and non-small cell lung cancer. The results of these clinical trials should further define the clinical benefit of bisphosphonates in the oncology setting.

Authors+Show Affiliations

Milton S. Hershey Medical Center, Penn State University, College of Medicine, 500 University Drive, Hershey, Pennsylvania 17033, USA. alipton@psu.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15459428

Citation

Lipton, Allan. "Toward New Horizons: the Future of Bisphosphonate Therapy." The Oncologist, vol. 9 Suppl 4, 2004, pp. 38-47.
Lipton A. Toward new horizons: the future of bisphosphonate therapy. Oncologist. 2004;9 Suppl 4:38-47.
Lipton, A. (2004). Toward new horizons: the future of bisphosphonate therapy. The Oncologist, 9 Suppl 4, 38-47.
Lipton A. Toward New Horizons: the Future of Bisphosphonate Therapy. Oncologist. 2004;9 Suppl 4:38-47. PubMed PMID: 15459428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Toward new horizons: the future of bisphosphonate therapy. A1 - Lipton,Allan, PY - 2004/10/2/pubmed PY - 2004/12/23/medline PY - 2004/10/2/entrez SP - 38 EP - 47 JF - The oncologist JO - Oncologist VL - 9 Suppl 4 N2 - Bisphosphonate therapy has become a standard of care for patients with malignant bone disease. In addition, preclinical and preliminary clinical data suggest that bisphosphonates may prevent cancer-treatment-induced bone loss (CTIBL) and the development of malignant bone disease in patients with early-stage cancer. Patients who receive adjuvant hormonal therapy for breast cancer or androgen-deprivation therapy for prostate cancer are at an especially high risk for CTIBL because of reduced estrogenic signaling. Oral clodronate (Bonefos; Anthra Pharmaceuticals; Princeton, NJ), oral risedronate (Actonel; Proctor and Gamble Pharmaceuticals, Inc.; Cincinnati, OH), and i.v. zoledronic acid (Zometa; Novartis Pharmaceuticals Corp.; East Hanover, NJ) have all demonstrated promise in preventing CTIBL in patients receiving hormonal therapy for breast cancer. Zoledronic acid has demonstrated efficacy with the longest between-treatment interval (3-6 months) and is currently being investigated in the Zometa/Femara Adjuvant Synergy Trials (Z-FAST and ZO-FAST in the United States and Europe, respectively). In patients receiving androgen-deprivation therapy for prostate cancer, i.v. pamidronate (Aredia; Novartis Pharmaceuticals Corp.) and i.v. zoledronic acid both have demonstrated significant benefits over placebo, but only zoledronic acid produced significant increases in bone mineral density compared with baseline values. Additionally, bisphosphonates have demonstrated antitumor activities in preclinical models, and clinical trials with oral clodronate suggest that bisphosphonates might prevent or delay bone metastasis in patients with early-stage breast cancer. Clinical trials are investigating the effect of zoledronic acid on disease progression in patients with breast cancer, prostate cancer, and non-small cell lung cancer. The results of these clinical trials should further define the clinical benefit of bisphosphonates in the oncology setting. SN - 1083-7159 UR - https://www.unboundmedicine.com/medline/citation/15459428/Toward_new_horizons:_the_future_of_bisphosphonate_therapy_ L2 - https://doi.org/10.1634/theoncologist.9-90004-38 DB - PRIME DP - Unbound Medicine ER -