THE ROLE OF BISPHOSPHONATES IN THE TREATMENT OF BONE METASTASES - THEUS EXPERIENCE

Frequent complications of bone metastases include pain, pathologic fra cture, hypercalcemia and spinal cord compression. Lytic bone metastase s result from excessive activation of osteoclasts by tumor-produced cy tokines. Aredia (pamidronate) is a potent bisphosphonate that inhibits osteoclast activation. In two dose-seeking phase I trials in patients with breast cancer and prostate cancer, repeated intravenous infusion of Aredia was shown to be safe and effective in reducing bone resorpt ion and pain. In a randomized phase III trial of 377 patients with mul tiple myeloma, Aredia was administered in a dosage of 90 mg i.v. every 4 weeks. Compared with placebo, treatment with Aredia was associated with a significant decrease in bone pain and in the incidence and time to development of all skeleton-related events. Data from two phase II I breast cancer trials each involving 300 patients are now being analy zed. The newer bisphosphonates can safely be used together with standa rd anticancer therapy to provide effective palliation of symptoms caus ed by lytic bone metastases.