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Bisphosphonates in multiple myeloma.
Cancer. 1997 Oct 15; 80(8 Suppl):1661-7.C

Abstract

The major clinical manifestations of multiple myeloma are related to enhanced bone destruction resulting in osteolytic lesions, osteoporosis, and pathologic fractures in most patients as well as hypercalcemia and spinal cord compression in many individuals. These patients frequently require radiation therapy or surgery. In an attempt to reduce these complications, bisphosphonates have been evaluated in several large randomized trials in patients also receiving chemotherapy. Oral etidronate given daily showed no clinical benefit, whereas the use of oral clodronate daily did reduce the development of new osteolytic lesions but did not significantly affect bone pain or rates of pathologic fractures. A large, randomized, double-blind study was conducted in which Stage III multiple myeloma patients received either pamidronate (90 mg) or placebo as a 4-hour infusion every 4 weeks for 21 cycles in addition to antimyeloma chemotherapy. The proportion of patients with at least one skeletal complication was significantly reduced in the pamidronate group compared with the placebo group. Although survival was not different between the pamidronate and placebo groups overall, patients in whom first-line chemotherapy had failed when they entered the trial lived longer with pamidronate treatment than those receiving placebo. Patients who received pamidronate had significant decreases in bone pain, had less analgesic drug use, and had better Eastern Cooperative Oncology Group performance status than patients receiving placebo. Pamidronate was safe and well tolerated during the trial.

Authors+Show Affiliations

West Los Angeles Veterans Affairs Medical Center and the Jonsson Comprehensive Cancer Center, University of California, 90073, USA.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Review

Language

eng

PubMed ID

9362433

Citation

Berenson, J R.. "Bisphosphonates in Multiple Myeloma." Cancer, vol. 80, no. 8 Suppl, 1997, pp. 1661-7.
Berenson JR. Bisphosphonates in multiple myeloma. Cancer. 1997;80(8 Suppl):1661-7.
Berenson, J. R. (1997). Bisphosphonates in multiple myeloma. Cancer, 80(8 Suppl), 1661-7.
Berenson JR. Bisphosphonates in Multiple Myeloma. Cancer. 1997 Oct 15;80(8 Suppl):1661-7. PubMed PMID: 9362433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bisphosphonates in multiple myeloma. A1 - Berenson,J R, PY - 1997/11/15/pubmed PY - 2000/6/20/medline PY - 1997/11/15/entrez SP - 1661 EP - 7 JF - Cancer JO - Cancer VL - 80 IS - 8 Suppl N2 - The major clinical manifestations of multiple myeloma are related to enhanced bone destruction resulting in osteolytic lesions, osteoporosis, and pathologic fractures in most patients as well as hypercalcemia and spinal cord compression in many individuals. These patients frequently require radiation therapy or surgery. In an attempt to reduce these complications, bisphosphonates have been evaluated in several large randomized trials in patients also receiving chemotherapy. Oral etidronate given daily showed no clinical benefit, whereas the use of oral clodronate daily did reduce the development of new osteolytic lesions but did not significantly affect bone pain or rates of pathologic fractures. A large, randomized, double-blind study was conducted in which Stage III multiple myeloma patients received either pamidronate (90 mg) or placebo as a 4-hour infusion every 4 weeks for 21 cycles in addition to antimyeloma chemotherapy. The proportion of patients with at least one skeletal complication was significantly reduced in the pamidronate group compared with the placebo group. Although survival was not different between the pamidronate and placebo groups overall, patients in whom first-line chemotherapy had failed when they entered the trial lived longer with pamidronate treatment than those receiving placebo. Patients who received pamidronate had significant decreases in bone pain, had less analgesic drug use, and had better Eastern Cooperative Oncology Group performance status than patients receiving placebo. Pamidronate was safe and well tolerated during the trial. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/9362433/Bisphosphonates_in_multiple_myeloma_ L2 - http://www.diseaseinfosearch.org/result/4962 DB - PRIME DP - Unbound Medicine ER -