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ASCO News About Bisphosphonates

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ASCO News About Bisphosphonates

There has been a long standing debate among the myeloma community concerning bisphosphonates.  Many myeloma docs now believe Zometa and Aredia provide anti-myeloma benefits, in addition to helping bones recover.  I received the following e-mail Friday from Larry, following release of pre-ASCO research data.  Larry represents a group of multiple myeloma patients who take this research very, very seriously.  Although he doesn’t have a science background, you can tell Larry really knows his stuff!  Here is the body of his e-mail:

The 2010 ASCO abstracts are available on their website. Of note, here are two that relate to recent discussions:  Bone marker assessment as a guide to chronic use of aminobisphosphonates in multiple myeloma:

“Our data suggests that NTX levels remain below 50 nMol/L for at least 6 months following a single dose of zoledronic acid once in remission. Increase in NTX level was predictive of boney and disease progression albeit in 1 patient and can potentially be used as a surrogate to tailor aBP therapy. Our data also suggests that less frequent dosing or a treatment holiday may be feasible in MM patients with stable disease”.

Note the last two sentences.

Evaluating the effects of zoledronic acid (ZOL) on overall survival (OS) in patients (Pts) with multiple myeloma (MM): Results of the Medical Research Council (MRC) Myeloma IX study:

This study compares Zometa vs. Clondronate administration in MM patients and it’s effect on overall survival. It seems to indicate that other “antimyeloma” therapy was given in addition to the bisphosphonate treatment, but it is not clear from the abstract whether that antimyeloma therapy was given in both arms of the study. From this study, it would appear that the Zometa arm generally had better overall survival and MIGHT be a study that lends credence to Zometa having anti-MM activity (although if administered together with other therapy, it might not be capable of such activity alone).
“Further, this also might support the notion that if one is using a bisphosphonate that has not been tested in trials on Myeloma patients (i.e. … one is not using pamidronate or zometa), one may not be deriving all the benefits of bisphosphonate treatment.”
Larry suggested I add the following disclaimer at the end of his comments:
I would add a disclaimer that this is editorial comment from someone that you know, and it should not be accepted as medical advice for individuals, which can only be obtained from a qualified physician.
Thank’s for helping get the word out about bisphosphonates, Larry!  As you can see–even if you only skimmed this article and read the statements in bold–the evidence is becoming clear that bisphosphonates do indeed contain anti-myeloma properties. 
I think we can all agree there are some very well informed readers out there in multiple myeloma cyberspace!  Feel good and keep smiling!  Pat