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IASLC: Bisphosphonate Therapy May Improve Survival in Metastatic NSCLC

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SEOUL, South Korea -- Lung cancer patients with bone metastases may live longer when treated with bisphosphonates, a study reported here suggests.

SEOUL, South Korea, Sept. 4 -- Lung cancer patients with bone metastases may live longer when treated with bisphosphonates, a study reported here suggests.

Patients with non-small-cell lung cancer (NSCLC) metastatic to bone had a median survival of 433 days when treated with zoledronic acid, Kostas Zarogoulidis, M.D., of Aristotle University in Thessaloniki, Greece, told attendees at the International Association for the Study of Lung Cancer's World Conference on Lung Cancer. In contrast, similar patients who did not receive the bisphosphonate had a median survival of 252 days (P=0.004).

"We found that treatment with bisphosphonates significantly increased survival and time to progression, as well," said Dr. Zarogoulidis. "We believe this improvement in survival is due to a direct antitumor effect of bisphosphonates, which has previously been shown in lung tumors."

Although bisphosphonates reduce skeletal morbidity in lung cancer, scant information is available on the drug's potential impact on time to progression and overall survival, he said.

So Dr. Zarogoulidis and colleagues retrospectively reviewed medical records on 108 patients with stage IIIb-IV non-small-cell lung cancer, 85 of whom had abnormal bone scans. All the patients had received the same chemotherapy regimen: paclitaxel 100 mg/m2 + carboplatin AUC 6.

In 55 of 85 patients with bone metastases, zoledronic acid 8 mg was administered intravenously every 21 days. The remaining 30 patients with bone metastases did not receive bisphosphonate therapy, nor did the 23 patients who had normal bone scans.

The primary objective was to assess overall survival, time to progression, and change in pain status. Both groups of patients who did not receive bisphosphonate therapy (those with and without bone metastases) had significantly worse survival compared with the group that received zoledronic acid (P=0.004 across groups).

Median survival in the metastatic group was 252 days, and patients with normal bone scans had a median survival of 255 days.

The survival advantage had a significant association with the number of cycles of bisphosphonate therapy (P

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