What are bisphosphonates?

Question

Used in the treatment of cancer.

Answer 1

Hi,


While "ganga" gave you a lot of "pat information" some of it is out of date: main line chemo is Thal/Dev, Revelimide and Velcade now with a couple of new trials going on, NEVER have alkylating agents (like Melph) for chemo if you want to have a stem cell transplant later (pre harvest) - damages stem cells so increases risk of a negative outcome.

THis drug is used for a couple of types of bone and other cancers but the 1# use is for patients with Multiple Myeloma

The drug you talked about is really a bone strengthener - called Adriena, Zometa or Pamidronate

You get them in an IV about once a month th help repair your bones from damage caused by the Myeloma cancer cell.

In some patients the drug also has an "antiz: iL-6" effect; that means it retards the cancer cell division.

There is a serious side effect you have to watch out for (8% of patients) call ONC (osteonecrosis of the jaw) - there is a lot of data on this at Mayo clinic. they suggest you be on bis's for no more than 3 years and that you keep very good dental care and NO work that would expose jaw bone to air (like having a tooth pulled)

When you get a treatments drink plenty of water before during and after to help protect you kidneys and try to get the infusion time lengthen to at least 2 hours for same reason.

The first couple of treatments it is going to make you very sleepy and lots joint / bone pain as it helps the body rebuild the dissolved bone, in most people this goes away in a few months; some times it doesn't.

A lot more information at:

www.multiplemyeloma.org
www.myeloma.org

good luck (36 Pamidronate treatments)

Jewells
36 months and still here

Answer 2

While gangahadar_nair is correct, I assume he cut and pasted it from some place. So, I will simply restate in laymans terms.

Healthy bone is constantly broken down and reformed. This is done by osteoclast (break down bone) and osteoblast (new bone creation). Some cancers (like multiple myeloma) simulate osteoclasts. In these cancers, there is a vicious feedback loop where products of the breakdown bone simulate further breakdown of bone. The symptoms created by excessive bone breakdown have been noted as hypercalemia (too much calcium in the blood), recurrent infections, bone pain, etc.

Bisphosphonates have a high affinity for bone tissue and, stop this feedback cycle by preventing the dissolution of hydroxylapatite, the principal bone mineral.

Note, this does nothing to the cancer itself. Bisphosphonates only treat a complication of the cancer (bone loss).

Answer 3

Multiple myeloma is a malignancy of plasma cells that produce monoclonal immunoglobulin and invade and destroy adjacent bone tissue. Common manifestations include bone pain, renal insufficiency, hypercalcemia, anemia, and recurrent infections. Diagnosis requires demonstration of M-protein (sometimes present in urine and not serum) and either lytic bone lesions, light-chain proteinuria, or excessive marrow plasma cells. A bone marrow biopsy is usually needed. Specific treatment includes conventional chemotherapy (usually with alkylating agents, corticosteroids, anthracyclines, or thalidomide) and high-dose melphalan followed by autologous peripheral blood stem cell transplantation.(Merck)
Many patients with myeloma develop bone disease. Bone disease can cause the bones to become thinner and weaker (osteoporosis), and it can make holes appear in the bone (lytic lesions). The weakened bone that results is more likely to break under minor pressure or injury (pathologic fracture). The bones most commonly affected are the axial skeleton (spine, pelvis, ribs, and skull) and the upper ends of the long bones of the arms and legs. Myeloma cells cause bone disease by sending signals to certain bone cells called osteoclasts, causing them to break down bone. In addition to giving rise to bone disease, this process also releases calcium; if this release happens too quickly, a condition called hypercalcemia can occur. Both myeloma bone disease and hypercalcemia can be treated with a group of drugs called bisphosphonates.
Please see the web pages for more details on Multiple myeloma and Bisphosphonates.

Answer 4

http://courses.washington.edu/bonephys/opbis.html