Treatment of Bone Metastases in Lung Cancer: The Actual Role of Zoledronic Acid

Thoracic Oncology Unit 1st, Lung Diseases Department, San Camillo-Forlanin High Specialization Hospitals, Rome, Italy.
Reviews on Recent Clinical Trials (Impact Factor: 1.07). 09/2009; 4(3):205-11. DOI: 10.2174/157488709789957718
Source: PubMed


Approximately 30-40% of NSCLC patients develop bone metastases. Bone metastases are associated with a significant increase in skeletal-related events (SREs), including severe bone pain, hypercalcemia, pathological fractures, spinal cord compression. These SREs result in impaired mobility, reduced quality of life, and frequently require therapeutic intervention (radiation therapy, surgery and systemic treatments). The normal balance of formation of new bone by osteoblasts and the resorption of old bone by osteoclasts becomes imbalanced and/or uncoupled, leading to the development of lesions that are osteolytic, osteoblastic, or a combination of both. The current National Comprehensive Cancer Network (NCCN) Clinical Practice Giudelines in Oncology recommend palliative external-beam radiotherapy for the treatment of bone metastases in patients with NSCLC and healthcare professionals treating such patients are urged to consider bisphosphonate therapy. Zoledronic acid is the first and only bisphosphonate that has proven efficacy for the treatment of bone metastases from a broad range of solid tumor types, including lung cancer.

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    • "Currently, the only kinds of therapies that can treat bone metastases are supportive therapies using 1) bisphosphonates to reduce osteolytic burden, 2) radiotherapy and analgesics to alleviate pain, and 3) surgical intervention to reinforce weak bones.24,118,119 The humanized monoclonal antibody to the IL-6 receptor, tocilizumab (Actemra®) was approved by the United States Food and Drug Administration (FDA) on January 11, 2010 and was previously approved in Japan and the European Medicines Agency (EMEA) in 2008 (Table 1).120 "
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