Metastatic
bone disease affects many
cancer patients and has a significant disease burden because of complications such as
pathologic fractures and severe
pain, which affect patient mobility and quality of life.
Bisphosphonates are the current standard of care for treating metastatic
bone disease. Available agents have shown varying degrees of efficacy in clinical trials, and treatment potential can be limited by efficacy, tolerance, or toxicity issues.
Ibandronate (
Bondronat); F. Hoffman-La Roche Ltd., Basel, Switzerland, http://www.roche.com) is a highly potent, single-
nitrogen bisphosphonate that is available in i.v. and oral formulations. In phase III trials in
breast cancer patients, both formulations reduced the incidence of skeletal complications associated with metastatic
bone disease and had significant and sustained effects on bone
pain and patient quality of life. Open-label studies of loading-dose
ibandronate administered over consecutive days suggest it also may be useful for relieving severe or
opioid-resistant metastatic bone
pain. New trials have been designed or are in progress that may extend the clinical indications of
ibandronate for patients with metastatic
bone disease.