Bone Metastases in Advanced Prostate Cancer

Abstract

Men with advanced prostate cancer are at high risk for development of bone metastases,resulting in clinically significant skeletal morbidity and severe bone pain. Studies of early-generation bisphosphonates,clodronate, and pamidronate,demonstrated transient palliative effects on bone pain in patients with bone metastases, but failed to demonstrate long-term clinical benefit.A small,open-label study of ibandronate demonstrated significant reductions in pain,but these results have not been confirmed in a larger,randomized,controlled trial. Currently,zoledronic acid is the only bisphosphonate that has demonstrated statistically significant reductions in skeletal morbidity – including durable pain reduction– in this patient population in a randomized placebocontrolled trial.Therefore,zoledronic acid therapy should be considered to prevent skeletal morbidity and improve the quality of life of prostate cancer patients with bone metastases.