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Oral versus intravenous ibandronic acid: a comparison of treatment options for metastatic bone disease

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Abstract

Purpose

This trial is the first to compare directly the clinical response to and safety of oral and intravenous (IV) ibandronic acid for metastatic bone disease.

Methods

Patients ≥18 years with breast, prostate, lung, urogenital or colon cancer received IV ibandronic acid 6 mg infused over 15 min every 28 days or oral ibandronic acid 50 mg/day. Clinical response was determined using bone scintigraphy, radiography and serum C-terminal telopeptide of type I collagen (S-CTX) at months 3–6. Adverse events and biochemical safety measures were recorded.

Results

A total of 84.6 and 88.5% of patients had a complete/partial response to IV and oral ibandronic acid, respectively. Median percentage decreases in S-CTX were −39 and −35%, respectively. Bone pain scores decreased and analgesic use increased from month 0–3 and were stable from months 3–6. Both formulations improved physical and functioning scores.

Conclusion

Oral and IV ibandronic acid for bone metastases have similar efficacy and tolerability.

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References

  • Berenson JR, Rosen LS, Howell A et al (2001) Zoledronic acid reduces skeletal-related events in patients with osteolytic metastases. Cancer 91:1191–1200. doi:10.1002/1097-0142(20010401)91:7<1191::AID-CNCR1119>3.0.CO;2-0

    Article  PubMed  CAS  Google Scholar 

  • Berruti A, Dogliotti L, Gorzegno G et al (1999) Differential patterns of bone turnover in relation to bone pain and disease extent in bone in cancer patients with skeletal metastases. Clin Chem 45:1240–1247

    PubMed  CAS  Google Scholar 

  • Body JJ, Diel IJ, Lichinitser MR, for the MF 4265 Study Group et al (2003) Intravenous ibandronate reduces the incidence of skeletal complications in patients with breast cancer and bone metastases. Ann Oncol 14:1399–1405. doi:10.1093/annonc/mdg367

    Article  PubMed  Google Scholar 

  • Body JJ, Diel IJ, Lichinitzer M et al (2004) Oral ibandronate reduces the risk of skeletal complications in breast cancer patients with metastatic bone disease: results from two randomised, placebo-controlled phase III studies. Br J Cancer 90:1133–1137. doi:10.1038/sj.bjc.6601663

    Article  PubMed  CAS  Google Scholar 

  • Body JJ, Lichinitser M, Tjulandin S, Garnero P, Bergstrom B (2007) Oral ibandronate is as active as intravenous zoledronic acid for reducing bone turnover markers in women with breast cancer and bone metastases. Ann Oncol 18:1165–1171. doi:10.1093/annonc/mdm119

    Article  PubMed  Google Scholar 

  • Brown JE, Thomson CS, Ellis SP, Gutcher SA, Purohit OP, Coleman RE (2003) Bone resorption predicts for skeletal complications in metastatic bone disease. Br J Cancer 89:2031–2037. doi:10.1038/sj.bjc.6601437

    Article  PubMed  CAS  Google Scholar 

  • Brown JE, Cook RJ, Major P et al (2005) Bone turnover markers as predictors of skeletal complications in prostate cancer, lung cancer, and other solid tumours. J Natl Cancer Inst 97:59–69

    Article  PubMed  CAS  Google Scholar 

  • Chang JT, Green L, Beitz J (2003) Renal failure with the use of zoledronic acid. N Engl J Med 349:1676–1679. doi:10.1056/NEJM200310233491721

    Article  PubMed  CAS  Google Scholar 

  • Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27:165–176. doi:10.1053/ctrv.2000.0210

    Article  PubMed  CAS  Google Scholar 

  • Coleman RE (2002) The clinical use of bone resorption markers in patients with malignant bone disease. Cancer 94:2521–2533. doi:10.1002/cncr.10522

    Article  PubMed  Google Scholar 

  • Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12(20 suppl):6243s–6249s. doi:10.1158/1078-0432.CCR-06-0931

    Article  PubMed  Google Scholar 

  • Coleman RE, Major P, Lipton A et al (2005) Predictive value of bone resorption and formation markers in cancer patients with bone metastases receiving the bisphosphonate zoledronic acid. J Clin Oncol 23:4925–4935. doi:10.1200/JCO.2005.06.091

    Article  PubMed  CAS  Google Scholar 

  • Diel IJ, Solomayer EF, Bastert G (2000) Treatment of metastatic bone disease in breast cancer: bisphosphonated. Clin Breast Cancer 1:43–51

    Article  PubMed  CAS  Google Scholar 

  • Domchek SM, Younger J, Finkelstein DM, Seiden MV (2000) Predictors of skeletal complications in patients with metastatic breast carcinoma. Cancer 89:363–368. doi:10.1002/1097-0142(20000715)89:2<363::AID-CNCR22>3.0.CO;2-3

    Article  PubMed  CAS  Google Scholar 

  • Garnero P (2001) Markers of bone turnover in prostate cancer. Cancer Treat Rev 27:187–192. doi:10.1053/ctrv.2000.0213

    Article  PubMed  CAS  Google Scholar 

  • Heidenreich A, Ohlmann C, Olbert P, Hegele A (2003) High-dose ibandronate is effective and well tolerated in the treatment of pain and hypercalcaemia due to metastatic urologic cancer. Eur J Cancer 1(Suppl 5):S270

    Google Scholar 

  • Jackson GH (2005) Renal safety of ibandronate. Oncologist 10(Suppl 1):14–18. doi:10.1634/theoncologist.10-90001-14

    Article  PubMed  CAS  Google Scholar 

  • Leyland-Jones B (2004) Pharmacokinetic and clinical equivalence of oral and intravenous ibandronate for metastatic bone disease. Eur J Cancer suppl 2:9–12

    Article  CAS  Google Scholar 

  • Lipton A, Demers L, Curley E et al (1998) Markers of bone resorption in patients treated with pamidronate. Eur J Cancer 34:2021–2026. doi:10.1016/S0959-8049(98)00277-9

    Article  PubMed  CAS  Google Scholar 

  • Lipton A, Hei Y, Coleman R, Major P, Cook R (2005) Suppression of bone turnover markers by zoledronic acid and correlation with clinical outcome. J Clin Oncol 23(Suppl 16 S):115 Abstract 532

    Google Scholar 

  • Markowitz GS, Fine PL, D’agati VD (2002) Nephrotic syndrome after treatment with pamidronate. Am J Kidney Dis 39:1118–1122. doi:10.1053/ajkd.2002.32797

    Article  PubMed  Google Scholar 

  • McPartland C, Grosjean L (2004) Treatment of painful bone metastases in Europe and Canada: the role of bisphosphonates. Ann Oncol 15(Suppl 3):iii50 abstract

    Google Scholar 

  • Menssen HD, Sakalová A, Fontana A et al (2002) Effects of long-term intravenous ibandronate therapy on skeletal-related events, survival, and bone resorption markers in patients with advanced multiple myeloma. J Clin Oncol 20:2353–2359. doi:10.1200/JCO.2002.02.032

    Article  PubMed  CAS  Google Scholar 

  • Mystakidou K, Katsouda E, Stathopoulou E, Vlahos L (2005) Approaches to managing bone metastases from breast cancer: the role of bisphosphonates. Cancer Treat Rev 31:303–311. doi:10.1016/j.ctrv.2005.03.005

    Article  PubMed  CAS  Google Scholar 

  • Ohlmann C, Heidenreich A (2003) Efficacy of ibandronate in the management of painful osseous metastases due to hormone refractory prostate cancer. Support Care Cancer 11:396 Abstract A–38

    Google Scholar 

  • Pecherstorfer M, Rivkin S, Body JJ, Diel I, Bergström B (2006) Long-term safety of intravenous ibandronic acid for up to 4 years in metastatic breast cancer: an open-label trial. Clin Drug Investig 26:315–322. doi:10.2165/00044011-200626060-00002

    Article  PubMed  CAS  Google Scholar 

  • Roodman GD (2004) Mechanisms of bone metastasis. N Engl J Med 350:1655–1664. doi:10.1056/NEJMra030831

    Article  PubMed  CAS  Google Scholar 

  • Vassiliou V, Kalogeropoulou C, Giannopoulou E, Leotsinidis M, Tsota I, Kardamakis D (2007) A novel study investigating the therapeutic outcome of patients with lytic, mixed and sclerotic bone metastases treated with combined radiotherapy and ibandronate. Clin Exp Metastasis 24:169–178. doi:10.1007/s10585-007-9066-x

    Article  PubMed  CAS  Google Scholar 

  • Yahara J, Noguchi M, Noda S (2003) Quantitative evaluation of bone metastasis in patients with advanced prostate cancer during systemic treatment. BJU Int 92:379–384. doi:10.1046/j.1464-410X.2003.04362.x

    Article  PubMed  CAS  Google Scholar 

  • Yau V, Chow E, Davis L, Holden L, Schueller T, Danjoux C (2004) Pain management in cancer patients with bone metastases remains a challenge. J Pain Symptom Manage 27:1–3. doi:D:10.1016/j.jpainsymman.2003.10.003

    Article  PubMed  Google Scholar 

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Acknowledgment

The authors received assistance from a medical communications agency in drafting the manuscript.

Conflict of interest

None of the authors has a conflict of interest.

Funding source

There is no sponsor or funding source to declare.

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Authors and Affiliations

  1. Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, University of Athens School of Medicine, 27 Korinthias St., 11526, Ampelokipi, Athens, Greece

    Kyriaki Mystakidou, Efi Parpa & Lambros Vlahos

  2. Genesis Pharma SA, 274 Kifisias Ave, 15232, Halandri, Athens, Greece

    Evangelia Stathopoulou

  3. Department of Radiology, Attikon University Hospital, Erimini 1, 12462, Chaidari, Athens, Greece

    Vassilios Kouloulias

  4. Department of Microbiology, Areteion Hospital, University of Athens School of Medicine, 76 Vas Sofias Ave., 11528, Athens, Greece

    Evangelia Kouskouni

Authors
  1. Kyriaki Mystakidou
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  2. Evangelia Stathopoulou
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  3. Efi Parpa
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  4. Vassilios Kouloulias
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  5. Evangelia Kouskouni
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  6. Lambros Vlahos
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Corresponding author

Correspondence to Kyriaki Mystakidou.

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Mystakidou, K., Stathopoulou, E., Parpa, E. et al. Oral versus intravenous ibandronic acid: a comparison of treatment options for metastatic bone disease. J Cancer Res Clin Oncol 134, 1303–1310 (2008). https://doi.org/10.1007/s00432-008-0419-x

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  • DOI: https://doi.org/10.1007/s00432-008-0419-x

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