Journal of Clinical Oncology, Vol 11, 491-498, Copyright © 1993 by American Society of Clinical Oncology
Palliative pamidronate treatment in patients with bone metastases from breast cancer
AT van Holten-Verzantvoort, HM Kroon, OL Bijvoet, FJ Cleton, LV Beex, G Blijham, J Hermans, JP Neijt, SE Papapoulos and HP Sleeboom
Department of Clinical Oncology, Leiden University Hospital, The Netherlands.
PURPOSE: An open, randomized study was performed to assess the effects of
supportive pamidronate treatment on morbidity from bone metastases in
breast cancer patients. PATIENTS AND METHODS: Eighty-one pamidronate
patients and 80 control patients were monitored for a median of 18 and 21
months, respectively, for events of skeletal morbidity and the radiologic
course of metastatic bone disease. The oral pamidronate dose was 600 mg/d
(high dose [HD]) during the earliest study years, then changed to 300 mg/d
(low dose [LD]) because of gastrointestinal toxicity. Twenty-nine of 81
pamidronate (HD/LD) patients first received 600 mg/d and were then changed
to 300 mg/d; 52 of 81 pamidronate LD patients received 300 mg/d throughout
the study. Tumor treatment was unrestricted. RESULTS: An overall
intent-to-treat analysis was performed. In the pamidronate group, the
occurrence of hypercalcemia, severe bone pain, and symptomatic impending
fractures decreased by 65%, 30%, and 50%, respectively; event-rates of
systemic treatment and radiotherapy decreased by 35% (P < or = .02). The
event-free period (EFP), radiologic course of disease, and survival did not
improve. Subgroup analyses suggested a dose-dependent treatment effect.
Compared with their controls, in pamidronate HD/LD patients, events
occurred 60% to 90% less frequently (P < or = .03) and the EFP was
prolonged (P = .002). In pamidronate LD patients, event-rates decreased by
15% to 45% (P < or = .04). Gastrointestinal toxicity of pamidronate
caused a 23% drop-out rate, but other cancer-associated factors seemed to
contribute to this toxicity. CONCLUSION: Pamidronate treatment of breast
cancer patients efficaciously reduced skeletal morbidity. The effect
appeared to be dose-dependent. Further research on dose and mode of
treatment is mandatory.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
S.L. Ruggiero and S.J. Drew
Osteonecrosis of the Jaws and Bisphosphonate Therapy
Journal of Dental Research,
November 1, 2007;
86(11):
1013 - 1021.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Clemons, G. Dranitsaris, D. Cole, and M. C. Gainford
Too Much, Too Little, Too Late to Start Again? Assessing the Efficacy of Bisphosphonates in Patients with Bone Metastases from Breast Cancer.
Oncologist,
January 1, 2006;
11(3):
227 - 233.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C Gainford, G. Dranitsaris, and M. Clemons
Recent developments in bisphosphonates for patients with metastatic breast cancer
BMJ,
April 2, 2005;
330(7494):
769 - 773.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Lussier, A. G. Huskey, and R. K. Portenoy
Adjuvant Analgesics in Cancer Pain Management
Oncologist,
September 1, 2004;
9(5):
571 - 591.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R Gralow
Bisphosphonates as adjuvant treatment for breast cancer
BMJ,
November 9, 2002;
325(7372):
1051 - 1052.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R. Berenson, R. A. Vescio, L. S. Rosen, J. M. VonTeichert, M. Woo, R. Swift, A. Savage, E. Givant, M. Hupkes, H. Harvey, et al.
A Phase I Dose-ranging Trial of Monthly Infusions of Zoledronic Acid for the Treatment of Osteolytic Bone Metastases
Clin. Cancer Res.,
March 1, 2001;
7(3):
478 - 485.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
T. Saarto, C. Blomqvist, P. Virkkunen, and I. Elomaa
Adjuvant Clodronate Treatment Does Not Reduce the Frequency of Skeletal Metastases in Node-Positive Breast Cancer Patients: 5-Year Results of a Randomized Controlled Trial
J. Clin. Oncol.,
January 1, 2001;
19(1):
10 - 17.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Mannix, S. H. Ahmedzai, H. Anderson, M. Bennett, M. Lloyd-Williams, and A. Wilcock
Using bisphosphonates to control the pain of bone metastases: evidence-based guidelines for palliative care
Palliative Medicine,
September 1, 2000;
14(6):
455 - 461.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. El Abdaimi, N. Dion, V. Papavasiliou, P.-E. Cardinal, L. Binderup, D. Goltzman, L.-G. Ste-Marie, and R. Kremer
The Vitamin D Analogue EB 1089 Prevents Skeletal Metastasis and Prolongs Survival Time in Nude Mice Transplanted with Human Breast Cancer Cells
Cancer Res.,
August 1, 2000;
60(16):
4412 - 4418.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
B. E. Hillner, J. N. Ingle, J. R. Berenson, N. A. Janjan, K. S. Albain, A. Lipton, G. Yee, J. S. Biermann, R. T. Chlebowski, and D. G. Pfister
American Society of Clinical Oncology Guideline on the Role of Bisphosphonates in Breast Cancer
J. Clin. Oncol.,
March 13, 2000;
18(6):
1378 - 1391.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Berruti, L. Dogliotti, G. Gorzegno, M. Torta, M. Tampellini, M. Tucci, S. Cerutti, M. Mosca Frezet, M. Stivanello, G. Sacchetto, et al.
Differential Patterns of Bone Turnover in Relation to Bone Pain and Disease Extent in Bone in Cancer Patients with Skeletal Metastases
Clin. Chem.,
August 1, 1999;
45(8):
1240 - 1247.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. L. Theriault, A. Lipton, G. N. Hortobagyi, R. Leff, S. Gluck, J. F. Stewart, S. Costello, I. Kennedy, J. Simeone, J. J. Seaman, et al.
Pamidronate Reduces Skeletal Morbidity in Women With Advanced Breast Cancer and Lytic Bone Lesions: A Randomized, Placebo-Controlled Trial
J. Clin. Oncol.,
March 1, 1999;
17(3):
846 - 846.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. AARON
Current Concepts Review - Treatment of Metastatic Adenocarcinoma of the Pelvis and the Extremities
J. Bone Joint Surg. Am.,
June 1, 1997;
79(6):
917 - 32.
[Full Text]
|
|
|
|
|
|
|
G. N. Hortobagyi, R. L. Theriault, L. Porter, D. Blayney, A. Lipton, C. Sinoff, H. Wheeler, J. F. Simeone, J. Seaman, R. D. Knight, et al.
Efficacy of Pamidronate in Reducing Skeletal Complications in Patients with Breast Cancer and Lytic Bone Metastases
N. Engl. J. Med.,
December 12, 1996;
335(24):
1785 - 1792.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R E Coleman
Therapeutic use of bisphosphonates in oncology
BMJ,
November 5, 1994;
309(6963):
1233b - 1233.
[Full Text]
|
|
|
|
