Role of pamidronate disodium in the treatment of metastatic bone disease

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

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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.
Lingua originaleEnglish
pagine (da-a)442-455
Numero di pagine14
RivistaTumori
Volume84
Stato di pubblicazionePublished - 1998

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cita questo

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