Does Clodronate Reduce Breast Cancer Metastases?
Initial data suggests clodronate (clodronic acid) reduces the incidence of both osseous and visceral metastases in high-risk patients with breast cancer. In addition, like other bisphosphonates, clodronate significantly reduces the incidence of skeletal complications associated with breast cancer, and is an important therapeutic option in the treatment of tumour-induced hypercalcaemia.
Oral or intravenous clodronate is generally well tolerated, with few serious adverse effects reported. The most common adverse effects are mild, transient gastrointestinal disturbances.
Approximately 60 to 80% of patients with breast cancer will develop bone metastases during the course of their disease, with two-thirds of these patients experiencing severe pain. Metastatic bone disease is a frequent cause of morbidity and complications (pathological fractures, hypercalcaemia and spinal cord compression) in these patients. The median survival time of patients from first metastatic relapse to death typically ranges from 18 months to 3 years, depending on the site and extent of metastases.
Since there is a high morbidity and poor prognosis associated with metastatic disease, current treatment strategies focus on relieving symptoms, preventing complications and improving quality of life with minimal inconvenience to the patient. Palliative treatments, including antineoplastic therapy, radiation therapy or hormone therapy, form the cornerstone of treatment for painful bone lesions. However, these palliative therapies do not alleviate the substantial morbidity from progressive skeletal involvement.
Metastatic bone disease is characterised by an impaired balance between bone resorption and bone formation, with osteolytic bone destruction being a predominant feature in patients with breast cancer. Treatments that prevent and/or relieve skeletal complications should reduce much of the morbidity associated with breast cancer. The bisphosphonates have an established role in the prevention and treatment of tumour-related complications such as fractures and hypercalcaemia. These agents have a high affinity for bone and, although their exact mechanism of action is unknown, they inhibit bone resorption by directly and/or indirectly inhibiting osteoclast activity.
Initial data suggests clodronate (clodronic acid) reduces the incidence of both osseous and visceral metastases in high-risk patients with breast cancer. In addition, like other bisphosphonates, clodronate significantly reduces the incidence of skeletal complications associated with breast cancer, and is an important therapeutic option in the treatment of tumour-induced hypercalcaemia.
Oral or intravenous clodronate is generally well tolerated, with few serious adverse effects reported. The most common adverse effects are mild, transient gastrointestinal disturbances.
Approximately 60 to 80% of patients with breast cancer will develop bone metastases during the course of their disease, with two-thirds of these patients experiencing severe pain. Metastatic bone disease is a frequent cause of morbidity and complications (pathological fractures, hypercalcaemia and spinal cord compression) in these patients. The median survival time of patients from first metastatic relapse to death typically ranges from 18 months to 3 years, depending on the site and extent of metastases.
Since there is a high morbidity and poor prognosis associated with metastatic disease, current treatment strategies focus on relieving symptoms, preventing complications and improving quality of life with minimal inconvenience to the patient. Palliative treatments, including antineoplastic therapy, radiation therapy or hormone therapy, form the cornerstone of treatment for painful bone lesions. However, these palliative therapies do not alleviate the substantial morbidity from progressive skeletal involvement.
Metastatic bone disease is characterised by an impaired balance between bone resorption and bone formation, with osteolytic bone destruction being a predominant feature in patients with breast cancer. Treatments that prevent and/or relieve skeletal complications should reduce much of the morbidity associated with breast cancer. The bisphosphonates have an established role in the prevention and treatment of tumour-related complications such as fractures and hypercalcaemia. These agents have a high affinity for bone and, although their exact mechanism of action is unknown, they inhibit bone resorption by directly and/or indirectly inhibiting osteoclast activity.
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