BERLIN, GERMANY (UroToday.com) - EAU 2007 - A poster session on “Management Options in Metastatic Prostate Cancer 2” took place at the EAU on Thursday March 22, 2007.

“Bisphosphonate Induced Osteonecrosis of the Jaw (ONJ) in Patients with Advanced Prostate Cancer. Risk Factors and Correlation with Clinical Parameters” was presented by Dr. Sountoulides, Alexandroupolis. Bisphosphonates delay the time to the first skeletal-related event and improve pain from bone metastasis in advanced CaP. Long-term use of bisphosphonates is associated with ONJ. The authors reported on 111 patients treated with androgen deprivation therapy and bisphosphonates (Zometa). Dental examinations were performed every 3 months and related parameters were recorded. During a 2.5 year period, 9 cases of ONJ were identified. The mean duration of Zometa therapy was 22 months and the mean cumulative dose was 72mg. In addition to exposed bone, 2 patients were asymptomatic (diagnosed during routine dental examination) but the majority presented with pain and one with loose teeth. Seven of the bone exposures were only in the mandible, and two in the maxilla. The incidence of ONJ correlated with the presence of greater bone involvement of their CaP with all 9 patients having >5 metastatic bone lesions on bone scans. The conclusion for regular dental examinations in patients on long-term Zometa seems prudent.

In another study on Zometa, Dr. Wirth, Dresden presented “Treatment with Zolendronic Acid is Beneficial before Onset of Skeletal Morbidity in Patients with Bone Metastases from Prostate Cancer”. The presentation included data from a 36 institution multi-center single arm trial of 308 patients with M+ CaP treated with zolendronic acid 4mg every 4 weeks for 15 months. The primary endpoint was skeletal related events and secondary endpoints such as improvement in pain were regularly assessed. Among 284 patients available for assessment, 67 (24%) had at least one SRE during the study period at a mean time of 11.5 months. Those without a prior SRE had a 59% reduced risk for an SRE and a longer mean time to first SRE (11.6 vs. 8.3 months for 36 men with a history of SRE). Patients with a prior SRE had an increased risk of another SRE. The data suggests that treatment with zolendronic acid prior to an SRE in CaP metastatic to bone may lower the risk of SREs and prolong time to the first SRE.

EAU 2007 Conference Coverage on UroToday.com

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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