Papel de los bifosfonatos para el tratamiento de las metástasis óseas y el mantenimiento de la salud ósea

The majority of patients with advanced cancer develop painful and debilitating bone metastases that are associated with long-term skeletal morbidity. Bone lesions lead to clinically significant skeletal complications including bone pain, pathologic fractures, and spinal cord compression. The clinical benefit of the third-generation bisphosphonate zoledronic acid for the prevention of skeletal complications in patients with metastatic bone disease has been previously reviewed (Lipton A. Cancer Invest. 2002;20[suppl 2]:45-54). Zoledronic acid has been shown to be at least as effective as pamidronate for the treatment of skeletal complications in patients with bone metastases secondary to breast cancer, and is the only bisphosphonate that has demonstrated a statistically significant reduction in the incidence and onset of skeletal complications compared with placebo in patients with bone metastases from prostate cancer, lung cancer, and other solid tumors. Herein, we present important updates to the information reviewed in the previous publication, as well as recent data that have emerged demonstrating the benefit of bisphosphonates for the reduction of bone pain in patients with metastatic disease and for the prevention of cancer treatment-induced bone loss and bone metastases in patients with nonmetastatic disease.