Role of pamidronate disodium in the treatment of metastatic bone disease

Carla Ripamonti, Fabio Fulfaro, Chiara Ticozzi, Alessandra Casuccio, Franco De Conno

Research output: Contribution to journalArticle

Abstract

Aims and Background: Bone metastases are a common feature of advanced neoplastic disease and are considered to be among the most frequent causes of pain and complications in oncologic patients. The main objective of the treatment of such patients is to control their symptoms and improve their quality of life. Pamidronate disodium is a second-generation bisphosphonate capable of inhibiting bone resorption (particularly osteoclast activity) without affecting bone remineralization. After a brief introduction concerning the pathophysiology of bone metastases and neoplastic bone pain, we herein present data on the clinical pharmacology and toxicity of bisphosphonates in general, and pamidronate in particular. We conclude by reviewing the literature on the use of pamidronate in phase II and III trials involving patients with metastatic bone disease. Methods: The paper is based on a review of articles published between 1984 and 1997 selected from the Cancerline and Medline databases. Results: In the considered phase II and III studies involving patients with bone metastases (breast cancer and multiple myeloma in particular), pamidronate proved to be efficacious in reducing the incidence of pain and skeletal complications, decreasing the excretion of metabolic markers of bone resorption and improving the quality of life. Intravenous infusions of 60-90 mg over a period of 2 hr every 3-4 weeks did not cause any significant toxic effects and was easily managed. Conclusions: Pamidronate is a bisphosphonate that is efficacious in the treatment of symptomatic bone metastases and can be considered an important therapeutic option in association with systemic treatments, radiotherapy and normal supportive care, especially in patients with breast cancer and multiple myeloma. Further randomized studies are necessary to confirm the positive preliminary results in other neoplasms, analyze the cost/benefit ratio of the treatment, and verify the possibility that, in addition to being used for palliative purposes, pamidronate may also prevent or delay the appearance of bone metastases.

Original languageEnglish
Pages (from-to)442-455
Number of pages14
JournalTumori
Volume84
Issue number4
Publication statusPublished - Jul 1998

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Keywords

  • Bone metastases
  • Palliative therapy
  • Pamidronate

ASJC Scopus subject areas

  • Cancer Research

Cite this

Ripamonti, C., Fulfaro, F., Ticozzi, C., Casuccio, A., & De Conno, F. (1998). Role of pamidronate disodium in the treatment of metastatic bone disease. Tumori, 84(4), 442-455.