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Updated: Feb 8, 2026
Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
Bisphosphonate anticancer activity in multiple myeloma
1Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra General Hospital, 11528 Athens, Greece. eterpos@med.uoa.gr
Abstract:
Bisphosphonates inhibit osteoclast-mediated bone resorption and have been used extensively to prevent skeletal-related events in patients with bone lesions from multiple myeloma (MM). In addition, in vitro and in vivo preclinical data suggest that bisphosphonates also have antimyeloma properties that may induce myeloma cell apoptosis, activate an anticancer immune response, inhibit angiogenesis, and reduce tumor burden, supporting an expanded role for bisphosphonates. Signals for improved survival in the clinic first emerged in retrospective analyses of MM patient subgroups in larger clinical trials. Recently, improved progression-free survival and overall survival with bisphosphonates have been reported in the overall populations of large-scale randomized clinical trials. Several ongoing clinical trials will help further define the role of bisphosphonates during antimyeloma therapy. Overall, bisphosphonates appear to be well tolerated in patients with MM; the most common adverse events are mild and can be easily managed. However, emphasis on renal monitoring and preventive dentistry are necessary to reduce the risk of potential adverse events, and have become the standard of care for patients with MM.
Insights
Bisphosphonates, used for multiple myeloma (MM), show promising survival benefits and antimyeloma effects. While generally well-tolerated, careful monitoring for adverse events is crucial for patients with MM.
Area of Science:
- Oncology
- Pharmacology
- Bone Biology
Background:
- Bisphosphonates are standard for preventing skeletal events in multiple myeloma (MM).
- Preclinical data suggest bisphosphonates possess direct antimyeloma properties.
- Emerging clinical data indicate survival benefits beyond bone protection.
Purpose of the Study:
- To review the evidence for bisphosphonates' antimyeloma effects.
- To summarize clinical trial data on survival outcomes with bisphosphonates in MM.
- To discuss the safety profile and standard care considerations for bisphosphonates in MM.
Main Methods:
- Review of preclinical studies (in vitro and in vivo).
- Analysis of retrospective and prospective clinical trials in MM patients.
- Evaluation of safety data and adverse event profiles.
Main Results:
- Bisphosphonates demonstrate antimyeloma activity, including apoptosis induction and immune response modulation.
- Recent large-scale trials show improved progression-free and overall survival with bisphosphonates in MM.
- Bisphosphonates are generally well-tolerated, with manageable side effects.
Conclusions:
- Bisphosphonates offer significant survival benefits in MM, extending beyond skeletal protection.
- Ongoing trials will further clarify their role in MM treatment regimens.
- Standard care includes renal monitoring and dental evaluation to mitigate risks.
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