Abstract
Bisphosphonates inhibit osteoclast-mediated bone resorption and have been used extensively to prevent skeletal-related events in patients with bone lesions from multiple myeloma (MM). In addition, in vitro and in vivo preclinical data suggest that bisphosphonates also have antimyeloma properties that may induce myeloma cell apoptosis, activate an anticancer immune response, inhibit angiogenesis, and reduce tumor burden, supporting an expanded role for bisphosphonates. Signals for improved survival in the clinic first emerged in retrospective analyses of MM patient subgroups in larger clinical trials. Recently, improved progression-free survival and overall survival with bisphosphonates have been reported in the overall populations of large-scale randomized clinical trials. Several ongoing clinical trials will help further define the role of bisphosphonates during antimyeloma therapy. Overall, bisphosphonates appear to be well tolerated in patients with MM; the most common adverse events are mild and can be easily managed. However, emphasis on renal monitoring and preventive dentistry are necessary to reduce the risk of potential adverse events, and have become the standard of care for patients with MM.
Keywords: Bisphosphonate, Bone lesion, Clodronate, Ibandronate, Multiple myeloma, Pamidronate, Survival, Zoledronic acid, Myeloma
Anti-Cancer Agents in Medicinal Chemistry
Title: Bisphosphonate Anticancer Activity in Multiple Myeloma
Volume: 12 Issue: 2
Author(s): Evangelos Terpos
Affiliation:
Keywords: Bisphosphonate, Bone lesion, Clodronate, Ibandronate, Multiple myeloma, Pamidronate, Survival, Zoledronic acid, Myeloma
Abstract: Bisphosphonates inhibit osteoclast-mediated bone resorption and have been used extensively to prevent skeletal-related events in patients with bone lesions from multiple myeloma (MM). In addition, in vitro and in vivo preclinical data suggest that bisphosphonates also have antimyeloma properties that may induce myeloma cell apoptosis, activate an anticancer immune response, inhibit angiogenesis, and reduce tumor burden, supporting an expanded role for bisphosphonates. Signals for improved survival in the clinic first emerged in retrospective analyses of MM patient subgroups in larger clinical trials. Recently, improved progression-free survival and overall survival with bisphosphonates have been reported in the overall populations of large-scale randomized clinical trials. Several ongoing clinical trials will help further define the role of bisphosphonates during antimyeloma therapy. Overall, bisphosphonates appear to be well tolerated in patients with MM; the most common adverse events are mild and can be easily managed. However, emphasis on renal monitoring and preventive dentistry are necessary to reduce the risk of potential adverse events, and have become the standard of care for patients with MM.
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Cite this article as:
Terpos Evangelos, Bisphosphonate Anticancer Activity in Multiple Myeloma, Anti-Cancer Agents in Medicinal Chemistry 2012; 12 (2) . https://dx.doi.org/10.2174/187152012799014986
DOI https://dx.doi.org/10.2174/187152012799014986 |
Print ISSN 1871-5206 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5992 |
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