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Current use of bisphosphonates in oncology. International Bone and Cancer Study Group.
J Clin Oncol. 1998 Dec; 16(12):3890-9.JC

Abstract

PURPOSE

The purpose of this article is to review the recent data on bisphosphonate use in oncology and to provide some guidelines on the indications for their use in cancer patients.

DESIGN

The group consensus reached by experts on the rationale for the use of bisphosphonates in cancer patients and their current indications for the treatment of tumor-induced hypercalcemia and metastatic bone pain in advanced disease and for the prevention of the complications of multiple myeloma and of metastatic bone disease are reviewed.

RESULTS

Bisphosphonates are potent inhibitors of tumor-induced osteoclast-mediated bone resorption. They now constitute the standard treatment for cancer hypercalcemia, for which we recommend a dose of 1,500 mg of clodronate or 90 mg of pamidronate; the latter compound is more potent and has a longer lasting effect. Intravenous bisphosphonates exert clinically relevant analgesic effects in patients with metastatic bone pain. Regular pamidronate infusions can also achieve a partial objective response by conventional International Union Against Cancer criteria and enhance the objective response rate to chemotherapy. In breast cancer, the prolonged administration of oral clodronate 1,600 mg daily reduces the frequency of morbid skeletal events by more than one fourth, whereas monthly pamidronate infusions of 90 mg for only 1 year in addition to chemotherapy reduce by more than one third the frequency of all skeletal-related events. The use of bisphosphonates to prevent bone metastases remains experimental. Last, bisphosphonates in addition to chemotherapy are superior to chemotherapy alone in patients with stages II and III multiple myeloma and can reduce the skeletal morbidity rate by approximately one half.

CONCLUSION

Bisphosphonate use is a major therapeutic advance in the management of the skeletal morbidity caused by metastatic breast cancer or multiple myeloma, although many questions remain unanswered, notably regarding the optimal selection of patients and the duration of treatment.

Authors+Show Affiliations

Institut J. Bordet, Université Libre de Bruxelles, Brussels, Belgium. jj.body@ib.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

9850035

Citation

Body, J J., et al. "Current Use of Bisphosphonates in Oncology. International Bone and Cancer Study Group." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 16, no. 12, 1998, pp. 3890-9.
Body JJ, Bartl R, Burckhardt P, et al. Current use of bisphosphonates in oncology. International Bone and Cancer Study Group. J Clin Oncol. 1998;16(12):3890-9.
Body, J. J., Bartl, R., Burckhardt, P., Delmas, P. D., Diel, I. J., Fleisch, H., Kanis, J. A., Kyle, R. A., Mundy, G. R., Paterson, A. H., & Rubens, R. D. (1998). Current use of bisphosphonates in oncology. International Bone and Cancer Study Group. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 16(12), 3890-9.
Body JJ, et al. Current Use of Bisphosphonates in Oncology. International Bone and Cancer Study Group. J Clin Oncol. 1998;16(12):3890-9. PubMed PMID: 9850035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current use of bisphosphonates in oncology. International Bone and Cancer Study Group. AU - Body,J J, AU - Bartl,R, AU - Burckhardt,P, AU - Delmas,P D, AU - Diel,I J, AU - Fleisch,H, AU - Kanis,J A, AU - Kyle,R A, AU - Mundy,G R, AU - Paterson,A H, AU - Rubens,R D, PY - 1998/12/16/pubmed PY - 2000/2/19/medline PY - 1998/12/16/entrez SP - 3890 EP - 9 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 16 IS - 12 N2 - PURPOSE: The purpose of this article is to review the recent data on bisphosphonate use in oncology and to provide some guidelines on the indications for their use in cancer patients. DESIGN: The group consensus reached by experts on the rationale for the use of bisphosphonates in cancer patients and their current indications for the treatment of tumor-induced hypercalcemia and metastatic bone pain in advanced disease and for the prevention of the complications of multiple myeloma and of metastatic bone disease are reviewed. RESULTS: Bisphosphonates are potent inhibitors of tumor-induced osteoclast-mediated bone resorption. They now constitute the standard treatment for cancer hypercalcemia, for which we recommend a dose of 1,500 mg of clodronate or 90 mg of pamidronate; the latter compound is more potent and has a longer lasting effect. Intravenous bisphosphonates exert clinically relevant analgesic effects in patients with metastatic bone pain. Regular pamidronate infusions can also achieve a partial objective response by conventional International Union Against Cancer criteria and enhance the objective response rate to chemotherapy. In breast cancer, the prolonged administration of oral clodronate 1,600 mg daily reduces the frequency of morbid skeletal events by more than one fourth, whereas monthly pamidronate infusions of 90 mg for only 1 year in addition to chemotherapy reduce by more than one third the frequency of all skeletal-related events. The use of bisphosphonates to prevent bone metastases remains experimental. Last, bisphosphonates in addition to chemotherapy are superior to chemotherapy alone in patients with stages II and III multiple myeloma and can reduce the skeletal morbidity rate by approximately one half. CONCLUSION: Bisphosphonate use is a major therapeutic advance in the management of the skeletal morbidity caused by metastatic breast cancer or multiple myeloma, although many questions remain unanswered, notably regarding the optimal selection of patients and the duration of treatment. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/9850035/Current_use_of_bisphosphonates_in_oncology__International_Bone_and_Cancer_Study_Group_ L2 - https://ascopubs.org/doi/10.1200/JCO.1998.16.12.3890?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -