Santini Daniele, Fratto Maria Elisabetta, Vincenzi Bruno, Galluzzo Sara, Tonini Giuseppe
University Campus Bio-Medico, Medical Oncology, Via Emilio Longoni 69, 00155 Rome, Italy.
Expert Opin Biol Ther. 2006 Dec;6(12):1333-48. doi: 10.1517/14712598.6.12.1333.
Bisphosphonate therapy has become a standard of therapy for patients with malignant bone disease. Moreover, in vivo preclinical and preliminary clinical data suggest that bisphosphonates may prevent cancer treatment-induced bone loss and the onset of malignant bone disease in patients with early-stage cancer. This comprehensive review critically reports the several preclinical evidences of action of bisphosphonates on osteoclasts, lymphocytes and tumour cells. In addition, all the clinical trials evaluating the effects of principal bisphosphonates on skeletal disease progression in patients with breast cancer, prostate cancer, non-small cell lung cancer and other cancers have been reported. Of the available bisphosphonates, intravenous zoledronic acid has demonstrated the broadest clinical activity and is actually approved for the treatment of bone metastases from any solid tumour in many countries. Renal safety is an important consideration for oncologists who are treating patients with bisphosphonates. This issue and the other topics relating to the safety of bisphosphonates are discussed in this review.
双膦酸盐疗法已成为恶性骨病患者的标准治疗方法。此外，体内临床前和初步临床数据表明，双膦酸盐可能预防癌症治疗引起的骨质流失以及早期癌症患者恶性骨病的发生。这篇综述批判性地报告了双膦酸盐对破骨细胞、淋巴细胞和肿瘤细胞作用的多项临床前证据。此外，还报告了所有评估主要双膦酸盐对乳腺癌、前列腺癌、非小细胞肺癌和其他癌症患者骨骼疾病进展影响的临床试验。在现有的双膦酸盐中，静脉注射唑来膦酸已显示出最广泛的临床活性，并且在许多国家实际上已被批准用于治疗任何实体瘤的骨转移。肾脏安全性是使用双膦酸盐治疗患者的肿瘤学家的重要考虑因素。本综述讨论了这个问题以及与双膦酸盐安全性相关的其他主题。
