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Are bisphosphonates the suitable anticancer drugs for the elderly?
Daniele Santini1, Maria Elisabetta Fratto, Sara Galluzzo
1Medical Oncology, University Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy. d.santini@unicampus.it
Critical Reviews in Oncology/Hematology
|August 12, 2008
Summary
Bisphosphonates effectively reduce skeletal-related events in elderly patients with bone metastases. Emerging evidence suggests these agents may also improve survival, warranting further investigation in clinical trials.
Area of Science:
- Geriatric Oncology
- Pharmacology
- Skeletal Metastases
Background:
- Bone metastases significantly impact elderly patients, increasing skeletal-related events (SREs), reducing quality of life, and decreasing survival.
- Bisphosphonates are established treatments for reducing and delaying SREs in patients with bone metastases, including the elderly.
Purpose of the Study:
- To review preclinical evidence supporting bisphosphonates' direct and indirect antitumor effects.
- To critically evaluate clinical data on bisphosphonate-associated survival benefits in elderly cancer patients.
- To analyze bisphosphonate safety and discuss clinical recommendations for elderly populations.
Main Methods:
- Review of preclinical studies (in vitro and in vivo).
- Analysis of retrospective and prospective clinical data.
- Examination of safety profiles and clinical guidelines (SIOG Society).
Main Results:
- Preclinical data suggest bisphosphonates possess antitumor properties.
- Clinical evidence indicates a potential survival benefit for elderly patients treated with bisphosphonates.
- Bisphosphonates are generally well-tolerated in the elderly population.
Conclusions:
- Bisphosphonates offer benefits beyond SRE reduction in elderly patients with bone metastases, including potential survival advantages.
- Ongoing randomized trials are crucial to confirm these survival benefits and may expand bisphosphonate indications.
- Adherence to safety profiles and clinical recommendations is essential for bisphosphonate use in the elderly.
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