Long-term safety and efficacy of bisphosphonate therapy in advanced lung cancer with bone metastasis

Aim: This retrospective, observational study evaluated the long-term (>12 months) safety and effectiveness of bisphosphonate. Methods: Data collected for 359 patients included quantity and proportion of adverse events (AEs) and skeletal-related events (SREs), and times to first AE and first SRE. Results: Patients in the <= 24-month group experienced significantly fewer AEs compared with the >24-month treatment group (p = 0.008), and treatment for >24 months was a potential risk factor for AEs (p = 0.05). Neither the proportion nor the risk of SRE was significantly associated with therapy duration (p = 0.525 and 0.084, respectively). Conclusion: Bisphosphonate treatment beyond 2 years may increase the risk of AEs, but may prolong SRE-free survival early after 24 months, compared with medication administered for <= 24 months. Plain language summary: The survival of patients with lung cancer with bone metastases has improved, just as the outcomes for many patients with cancer have improved. Bisphosphonate is the standard drug used for bone metastasis of lung cancer, but its safety and effectiveness when used for more than 2 years have not been finally decided. This study reviewed and analyzed the records of 359 patients who received bisphosphonate treatment for up to 24 months or longer than 24 months. It was determined that bisphosphonate used for more than 24 months may increase the risk of calcium deficiency in the bloodstream (hypocalcemia) and kidney disease, but may also delay the development of bone pain, fracture and spinal cord compression or the need for bone radiotherapy or surgery.