Other Tumours with Osteotropic Metastases
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Bone marrow biopsies demonstrated that at least 15% of patients with adenocarcinoma of the lungs already have bone marrow metastases at the time of diagnosis. Autopsy studies have shown an incidence of 35%. These metastases evoke variable osseous reactions. Relatively few studies on the effects of bisphosphonates have been carried out, possibly because of the short survival times—a matter of months—of patients with bronchial cancer once metastases are established. However, the studies that have been published have shown a positive effect of bisphosphonates on the reduction of SREs as well as delay in the time to occurrence of the first SREs. Moreover, in these patients, a prolongation of even a few months to occurrence of the first SRE is significant, and BP reduce skeletal morbidity regardless of SRE history. The rapid analgesic effect of BP (within 2 days) was also observed in these patients. Recent studies have emphasised the need for early identification of patients at risk and the beneficial role of the latest BP in the management of patients with advanced metastatic bone disease. It is also of interest that BP induced apoptosis in cells derived from adenocarcinomas of the lungs in experimental and in “in vitro” investigations. This has promising implications for future therapy.