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Bone antiresorptives, mostly bisphosphonates, are used in the treatment of metastatic bone disease from solid malignancies to reduce bone destruction, pain and skeleton-related events (SREs). Von Moos and colleagues [1] have reported pooled results from three randomized, identically designed, double-blind trials comparing subcutaneous denosumab (120 mg every 4 weeks) and intravenous zoledronic acid (4 mg/month) in patients with bone metastases from breast cancer ([i]n[/i] = 2406), castration-resistant prostate cancer ([i]n[/i] = 1901) or other solid tumors ([i]n[/i] = 1597). The endpoints were pain severity, pain interference, health-related quality of life and analgesic use. Onset of moderate/severe pain was delayed by 1.8 months by denosumab treatment (hazard ratio (HR) 0.83; 95% CI 0.76–0.92; [i]p[/i]  <  0.001) and clinically meaningful increases in overall pain interference by 2.6 months (HR 0.83; 95% CI 0.75–0.92; [i]p[/i] <  0.001) as compared with zoledronic acid. In addition, the need for strong opioids and reduction of health-related quality of life were less common with denosumab.

Author(s)

  • Faustino R. Pérez-López
    Professor of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine & Lozano Blesa University Hospital, Zaragoza, Spain

Citations

  1. von Moos R, Body JJ, Egerdie B, et al. Pain and health-related quality of life in patients with advanced solid tumours and bone metastases: integrated results from three randomized, double-blind studies of denosumab and zoledronic acid. Support Care Cancer 2013;21:3497-507
    http://www.ncbi.nlm.nih.gov/pubmed/23975226
  2. Ellis GK, Bone HG, Chlebowski R, et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J Clin Oncol 2008;26:4875-82
    http://www.ncbi.nlm.nih.gov/pubmed/18725648
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    http://www.ncbi.nlm.nih.gov/pubmed/22641239
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    http://www.ncbi.nlm.nih.gov/pubmed/24782453
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  8. Wang X, Yang KH, Wanyan P, Tian JH. Comparison of the efficacy and safety of denosumab versus bisphosphonates in breast cancer and bone metastases treatment: A meta-analysis of randomized controlled trials. Oncol Lett 2014;7:1997-2002
    http://www.ncbi.nlm.nih.gov/pubmed/24932278
  9. Coleman RE, Major P, Lipton A, et al. Predictive value of bone resorption and formation markers in cancer patients with bone metastases receiving the bisphosphonate zoledronic acid. J Clin Oncol 2005;23:4925-35
    http://www.ncbi.nlm.nih.gov/pubmed/15983391
  10. Fizazi K, Bosserman L, Gao G, Skacel T, Markus R. Denosumab treatment of prostate cancer with bone metastases and increased urine N-telopeptide levels after therapy with intravenous bisphosphonates: results of a randomized phase II trial. J Urol 2013;189(1 Suppl):S51-7
    http://www.ncbi.nlm.nih.gov/pubmed/23234632
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