Efficacy of Quadramet® (QUA) as treatment of painful bone metastasis: A large single-center study

Abstract

Background: The aim of this study was to assess the efficacy of QUA (153Sm-EDTMP ethylene-diamin-tetramethylene-phosphonate]) in a real-life setting. Method(s): We have conducted a retrospective study of all consecutive patients ( pts) treated with QUA for painful bone metastases, according to marketing authorization (e.g. painful bony met., with hot spots on bone scintigraphy). QUA have been administered IV at the dose of 37 MBq/kg. At each visit (before treatment, and D15 and D30 after treatment), 4 parameters were collected: (i) pain assessment using 10 steps visual analogue scale (VAS) (0 to 10), (ii) presence or absence of sleep disturbance related to pain, (iii) dose of analgesic medication, and (iv) answer to the following closed question "Do You think You get a benefit of treatment ?". Success of treatment was defined by a combined criterion including these 4 parameters. Result(s): From January 2001 to December 2012, 370 consecutive QUA treatments for painful bone met. were delivered in our department. Primary tumors were: breast carcinoma (153), prostatic carcinoma (155), lung carcinoma (27), or other cancers (35). Mean age of the pts was 65 +/- 12 yrs. Fifty-eight percent of the pts had previous external osseous radiotherapy. Ninety-seven percent of pts had concomitant analgesics and 61% were under diphosphonates. Pts described benefit in 46.0% [95%-CI: 40.7 - 51.5] of cases at Day 15 and 55.0% [95%-CI: 48.8 - 60.7] at D30. Treatment was more effective in cases of breast and prostate cancers compared to other primaries. Pts described benefit at D15 in 50%, 48%, 29%, and 33% of cases for breast, prostate, lung and others cancers, respectively (p= 0.12). Pts described benefit at D30 in 62%, 58%, 6%, and 38% of cases for breast, prostate, lung and others cancers, respectively (p < 0.001). Subjective efficacy was accompanied by a decrease in analgesic intake in 35.0% of cases. Conclusion(s): QUA therapy is an effective supportive treatment in pts suffering from bony met, especially in breast and prostate cancer pts.