May 17, 2012

Reducing Bone Cancer with Drugs: The Debate

(Ivanhoe Newswire) -- New research shows when it comes to bone-cancer-related fractures, pain can be reduced by drug treatment, but no one drug is superior. Researchers undertook a systematic review of the current evidence on bisphosphonate drugs, which are used to prevent bone damage in multiple myeloma.

Severe back pain is a common symptom of multiple myeloma–a type of cancer that can cause fractures in long bones and the spine. Bisphosphonate drugs may help to reduce the occurrence of fractures and bone pain in myeloma patients. While many different bisphosphonate drugs are available, their relative merits are uncertain.

The researchers analyzed data from 20 trials involving a total of 6,692 patients who took bisphosphonate drugs including zoledronate, clodronate, pamidronate, ibandronate and etidronate in addition to their myeloma treatments. Bisphosphonates reduced the occurrence of fractures and pain. For all types of fractures, the researchers estimated that between 6 and 15 patients would need to be treated to prevent fractures in one patient. For pain, between 5 and 13 patients would need to be treated to reduce pain in one patient.

Head-to-head trials comparing effects of the drugs with no drugs or placebos suggested that zoledronate was more effective at reducing fractures compared to etidronate, but taken together with the indirect comparisons, the researchers conclude that no one drug can be regarded as superior.

"Whether zoledronate is superior to any other bisphosphonate drug remains an open question," lead researcher Ambuj Kumar of the Center for Evidence Based Medicine and Health Outcomes Research at the University of South Florida, in Tampa, Florida was quoted as saying.

"In light of the inconsistencies we see in the data, it is difficult to recommend any drug as a preferential treatment for clinical practice."

The review showed adverse effects of bisphosphonate drugs appear to be rare.

SOURCE: Cochrane Library, May 2012