Aredia: the once-monthly infusion for the treatment of bone metastases.

Cancer cells produce a variety of cytokines that stimulate osteoclasts to resorb bone, leading to cancer-mediated destruction of the skeleton. Bisphosphonates, which are deposited on the surface of bone as a response to increased resorption, are potent inhibitors of this osleoclastic resorption. Several studies have suggested that bisphosphonate therapy can retard the formation of new bone metastases in patients with metastatic bone disease. First-generation bisphosphonates (etidronate and clodronate) were not suitable for long-term treatment and have now been superseded by second-generation bisphosphonates (pamidronate), which are more potent and do not have adverse effects on bone mineralization. Further generations of these drugs have now entered clinical trials.