Can bisphosphonates improve treatment outcomes for patients with lung cancer spread to the bones?

This study evaluated whether zoledronate (Zometa) combined with TKI therapy is more effective than TKI therapy alone for patients with non-small cell lung cancer (NSCLC) spread to the bones. This study concluded that adding zoledronate to TKI therapy improved survival outcomes for these patients.

NSCLC is the most common type of lung cancer. 30 to 40% of patients experience bone metastasis. This is when cancer spreads into the bone. This complication can lead to problems with the bones, such as fractures, pain, and high calcium levels in the blood. Bisphosphonates (BP) are agents that can help treat these problems. Zoledronate (Zometa) is a BP that is also used to help treat cancers that have spread to the bone.

Previous studies suggest that zoledronate may block the growth and spread of NSCLC cells. Tyrosine kinase inhibitor (TKI) therapy is a standard treatment for NSCLC. TKI therapy works inside cancer cells and blocks signals needed for tumors to grow. Whether zoledronate combined with TKI therapy is more effective for NSCLC that has spread to the bone compared to TKI therapy alone is unclear.

This study had 129 patients with NSCLC. They were separated into 2 groups. One group received BP therapy (zoledronate) and one group did not. 49 patients received TKI therapy as a first-line treatment. Among these patients, 32 received zoledronate plus TKI therapy (combination group), and 19 received TKI therapy only.

Overall, patients who received zoledronate survived for significantly longer without tumor growth or spread compared to patients who did not (7.1 months vs. 5.1 months). Zoledronate was significantly associated with a 49% lower risk of tumor growth or spread.

Patients who received combination treatment (TKI + BP) survived for significantly longer on average compared to patients who had TKI therapy only (31 months vs. 22 months). Zoledronate plus TKI therapy was significantly associated with a 69% lower mortality risk.

Patients who received combination treatment survived on average for significantly longer without tumor growth or spread compared to patients who had TKI therapy only (11.2 months vs. 6.9 months). Zoledronate plus TKI therapy was significantly associated with an 87% lower risk of tumor growth or spread.

This study concluded that patients who received zoledronate and TKI therapy had significantly longer survival compared to patients who had TKI therapy only. The authors suggest that BP treatment should be added to treatment regimens for patients with NSCLC that has spread to the bone.

This was a small study that only included Chinese patients. These results may not apply to all patients. More studies are needed to confirm these results.