Bisphosphonates reduce skeletal morbidity of metastatic cancer

Bisphosphonate therapy has a beneficial effect on most skeletal outcomes in cancer patients with bone metastases, according to a report published in the August 30th issue of the British Medical Journal.

The findings are based on a systematic review of 30 controlled trials that investigated bisphosphonate use in patients with metastatic bone disease.In studies with at least 6 months of follow-up, bisphosphonate therapy reduced the risk of vertebral and non-vertebral fractures by 35% compared with placebo use, lead author Dr. Joy R. Ross, from the Royal Marsden Hospital in London, and colleagues note. No skeletal benefit was seen when these drugs were taken for less than 6 months.Bisphosphonate therapy was also associated with a lower risk of hypercalcemia and with a reduced need for radiotherapy. Moreover, bisphosphonates significantly increased the time to first skeletal-related event, suggesting that treatment should begin as soon as bone metastases are detected.In studies lasting longer than 1 year, there was also evidence that bisphosphonates reduced the need for orthopedic surgery (p = 0.009). Bisphosphonate therapy did not seem to improve survival or reduce the risk of spinal cord compression, the investigators note.Although the best drug remains to be determined, in the current analysis, intravenous aminobisphosphonates appeared to be more effective than oral agents, the researchers state.”Further research is needed to determine the optimum regimen required to treat patients with bone metastases,” the authors state. “Clinical trials of bisphosphonates in other disease groups are needed.”(Source: BMJ 2003;327:469-472: Reuters Health: August 28, 2003: Oncolink)