Medical Oncology

, Volume 25, Issue 3, pp 356–359

Renal safety of zoledronic acid administration beyond 24 months in breast cancer patients with bone metastases

  • Murat Dincer
  • Kadri Altundag
  • Hakan Harputluoglu
  • Sercan Aksoy
  • Mustafa Cengiz
  • Ibrahim Gullu
Original Paper

Abstract

Zoledronic acid (ZA) delays the onset or reduces the incidence of skeletal complications in breast cancer patients with bone metastases. However, there are few data on the long-term renal safety of ZA. We retrospectively evaluated 43 breast cancer patients with bone metastases who received ZA more than 24 months. The following parameters measured prior to first ZA use and after the last dose of ZA administration were compared: serum creatinine (SCr), blood urea nitrogen (BUN), alkaline phosphatase (ALP), calcium (Ca), and phosphorous (P). Forty-three breast cancer patients with documented bone metastases were evaluated. Median age at the start of treatment was 53 years (range 37–77). Median overall duration of ZA administration was 36 months (25–62). There were no statistically significant differences in the pre- and post-treatment levels of SCr, BUN, Ca and P. However, ALP levels after long-term ZA administration were decreased significantly (P < 0.05). More than 24 months of ZA administration did not adversely affect the renal function. ZA can be used safely in breast cancer patients with bone metastases beyond 2 years.

Keywords

Zoledronic acid Renal safety Breast cancer Bone metastases 

References

  1. 1.
    Manders K, van de Poll-Franse LV, Creemers GJ. Clinical management of women with metastatic breast cancer: a descriptive study according to age group. BMC Cancer. 2006;6:179.PubMedCrossRefGoogle Scholar
  2. 2.
    Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev. 2001;27:165–76.PubMedCrossRefGoogle Scholar
  3. 3.
    Pavlakis N, Schmidt R, Stockler M. Bisphosphonates for breast cancer. Cochrane Database Syst Rev 2005(3):CD003474.Google Scholar
  4. 4.
    Lipton A. Management of bone metastases in breast cancer. Curr Treat Options Oncol 2005;6:161–71.PubMedCrossRefGoogle Scholar
  5. 5.
    Bounameaux HM, et al. Renal failure associated with intravenous diphosphonates. Lancet 1983;1:471.PubMedCrossRefGoogle Scholar
  6. 6.
    Zojer N, Keck AV, Pecherstorfer M. Comparative tolerability of drug therapies for hypercalcaemia of malignancy. Drug Saf 1999;21:389–406.PubMedCrossRefGoogle Scholar
  7. 7.
    Markowitz GS, et al. Toxic acute tubular necrosis following treatment with zoledronate (Zometa). Kidney Int 2003;64:281–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Ali SM, Esteva FJ, Hortobagyi G. Safety and efficacy of bisphosphonates beyond 24 months in cancer patients. J Clin Oncol 2001;19:3434–7.PubMedGoogle Scholar
  9. 9.
    Guarneri V, Donati S, Nicolini M, Giovannelli S, D’Amico R, Conte PF. Renal safety and efficacy of i.v. bisphosphonates in patients with skeletal metastases treated for up to 10 years. Oncologist. 2005;10:842–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 2006;17:897–907.PubMedCrossRefGoogle Scholar
  11. 11.
    Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31–41.PubMedCrossRefGoogle Scholar
  12. 12.
    Chang JT, Green L, Beitz J. Renal failure with the use of zoledronic acid. N Engl J Med 2003;349:1676–9 (discussion 1676–9.).PubMedCrossRefGoogle Scholar
  13. 13.
    Markowitz GS, et al. Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate. J Am Soc Nephrol 2001;12:1164–72.PubMedGoogle Scholar
  14. 14.
    Gokden N, et al. Potential effect of zoledronate therapy in heavy proteinuria. Clin Nephrol 2007;67:263–5.PubMedGoogle Scholar
  15. 15.
    Balla J. The issue of renal safety of zoledronic acid from a nephrologist’s point of view. Oncologist 2005;10:306–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Altundag O, et al. Calcium and vitamin D supplementation during bisphosphonate administration may increase osteoclastic activity in patients with bone metastasis. Med Hypotheses. 2004;63:1010–3.PubMedCrossRefGoogle Scholar
  17. 17.
    Aguiar Bujanda D, Bohn Sarmiento U, Cabrera Suarez MA, Aguiar Morales J. Assessment of renal toxicity and osteonecrosis of the jaws in patients receiving zoledronic acid for bone metastasis. Ann Oncol 2007;18:556–60.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2008

Authors and Affiliations

  • Murat Dincer
    • 1
  • Kadri Altundag
    • 1
  • Hakan Harputluoglu
    • 1
  • Sercan Aksoy
    • 1
  • Mustafa Cengiz
    • 2
  • Ibrahim Gullu
    • 1
  1. 1.Department of Medical OncologyHacettepe University Institute of OncologyAnkaraTurkey
  2. 2.Department of Radiation OncologyHacettepe University Institute of OncologyAnkaraTurkey

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