|
|
|
|
||
|
||
|
|
||
| SEARCH | SUBSCRIBE | ||
Want to support Global Action on Aging? Click below: Thanks!
|
 |
Bone
Loss Prevention Drug Showing Promise in Advanced Prostate Cancer By
Linda Wang September
2, 2003 Oral
sodium clodronate may slow the development of symptomatic bone metastases
and reduce the risk of death in men with advanced prostate cancer,
according to a randomized controlled trial in the September 3 issue of the
Journal of the National Cancer Institute. Prostate
cancer spreads most commonly to the bone, and bone metastases affect at
least 85% of men with advanced prostate cancer. Bisphosphonates, including
sodium clodronate, reduce bone loss. In the early 1990s, researchers in
the United Kingdom initiated two phase III trials to examine the benefit
of bisphosphonates in men with advanced prostate cancer. The results of
one of these trials is now being reported. David
P. Dearnaley, M.D., of the Institute of Cancer Research and Royal Marsden
Hospital in Sutton, United Kingdom; Matthew R. Sydes, M.Sc., of the
Medical Research Council Clinical Trials Unit in London; and their
colleagues randomly assigned 311 men who were starting or responding to
hormone therapy for bone metastases to receive either oral sodium
clodronate or a placebo for up to 3 years. After
approximately 5 years of follow up, men in the active treatment group had
a 21% reduction in the risk of symptomatic bone progression and a 20%
reduction in the risk of death, compared with men in the placebo group.
However, these findings were not statistically significant. The authors
note several limitations to the study, such as the small population size
and the use of an oral rather than an intravenous bisphosphonate. Oral
bisphosphonates are poorly absorbed by the body. Patients
in the sodium clodronate group did have a statistically significant 29%
increase in the time before their performance status deteriorated.
However, men who received sodium clodronate had a 71% greater risk of side
effects. These effects were reversed when the drug dose was modified. A
subgroup analysis suggested that clodronate might be more effective in men
with more recently diagnosed disease. "Further
data are needed that reflect the availability of the newer, more potent
bisphosphonates as well as the changing patterns of care for men with
prostate cancer," the authors write, adding that more research will
help to identify appropriate patient populations for treatment and to
determine the appropriate type, dose, and duration of bisphosphonate
therapy. Preliminary results from the parallel study should be available
next year. In
an accompanying editorial, Fred Saad, M.D., of the University of Montreal
Hospital Center in Canada, says that although the current findings are not
statistically significant, they provide "at least some evidence that
starting bisphosphonates earlier in the metastatic state may give better
results." "Research
into the earlier use of bisphosphonates in metastatic prostate cancer as
well as into the potential of bisphosphonates to actually prevent
metastases is ongoing," he writes. "With a better understanding
of the role of bisphosphonates in treatment-induced bone loss, prevention
and treatment of metastases, and antitumor effects, it is most likely that
the role they play will expand in the management of advanced prostate
cancer."
Copyright
© 2002 Global Action on Aging
|
