Journal of Clinical Oncology, Vol 10, 134-142, Copyright © 1992 by American Society of Clinical Oncology

ARTICLES

Comparative study of pamidronate disodium and etidronate disodium in the treatment of cancer-related hypercalcemia

R Gucalp, P Ritch, PH Wiernik, PR Sarma, A Keller, SP Richman, K Tauer, J Neidhart, LE Mallette and R Siegel
Albert Einstein College of Medicine/Montefiore Medical Center, Department of Oncology, Bronx, NY 10467.

PURPOSE: This multicenter, double-blind, randomized trial was performed to determine the efficacy and safety of pamidronate disodium (APD) in comparison to etidronate disodium (EHDP) in the treatment of cancer- related hypercalcemia. PATIENTS AND METHODS: Sixty-five male and female adult patients with cancer and corrected calcium levels of greater than or equal to 12.0 mg/dL after 24 hours of hydration were randomized to receive either 60 mg APD given as a single 24-hour infusion or 7.5 mg/kg EHDP given as a 2-hour infusion daily for 3 days. RESULTS: APD normalized corrected calcium levels in 70% (21 of 30) of patients, whereas EHDP did so in 41% (14 of 34) of patients (P = .026). The mean corrected serum calcium level decreased from 14.6 to 10.5 mg/dL in the APD-treated group and from 13.8 to 11.6 mg/dL in the EHDP-treated group within the first week of treatment. There was no difference in response to APD in patients without versus those with bone metastases (78% v 67%). Both drugs were well tolerated. CONCLUSION: This study demonstrated that a single 60-mg infusion of APD is safe and more effective than EHDP given at the dose of 7.5 mg/kg for 3 days in the treatment of cancer-related hypercalcemia.
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