Originally published as JCO Early Release 10.1200/JCO.2007.12.1269 on May 21 2007
Journal of Clinical Oncology, Vol 25, No 17 (June 10), 2007: pp. 2464-2472
© 2007 American Society of Clinical Oncology.
American Society of Clinical Oncology 2007 Clinical Practice Guideline Update on the Role of Bisphosphonates in Multiple Myeloma
Robert A. Kyle,
Gary C. Yee,
Mark R. Somerfield,
Patrick J. Flynn,
Susan Halabi,
Sundar Jagannath,
Robert Z. Orlowski,
David G. Roodman,
Patricia Twilde,
Kenneth Anderson
From the Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester; Minnesota Oncology Hematology, P.A., Minneapolis, MN; St Vincent's Comprehensive Cancer Center, New York, NY; Duke University Medical Center, Durham; University of North Carolina at Chapel Hill, Chapel Hill, NC; VA Pittsburgh Healthcare System, Pittsburgh, PA; and University of Nebraska Medical Center, Omaha, NE
Address reprint requests to the American Society of Clinical Oncology, 1900 Duke St, Ste 200, Alexandria, VA 22314; e-mail: guidelines{at}asco.org
Purpose: To update the recommendations for the use of bisphosphonates in the prevention and treatment of bone disease in multiple myeloma. The Update Committee expanded the guideline to include a discussion of osteonecrosis of the jaw (ONJ).
Methods: For the 2007 update, an Update Committee composed of members from the full panel completed a review and analysis of data published since 2002. Searches of Medline and the Cochrane Collaboration Library databases were performed.
Recommendations: For multiple myeloma patients who have, on plain radiograph(s) or imaging studies, lytic destruction of bone or spine compression fracture from osteopenia, intravenous pamidronate 90 mg delivered over at least 2 hours or zoledronic acid 4 mg delivered over at least 15 minutes every 3 to 4 weeks is recommended. Clodronate is an alternative bisphosphonate approved worldwide, except in the United States, for oral or intravenous administration. New dosing guidelines for patients with pre-existing renal impairment were added to the zoledronic acid package insert. Although no similar dosing guidelines are available for pamidronate, the Update Committee recommends that clinicians consider reducing the initial pamidronate dose in patients with pre-existing renal impairment. Zoledronic acid has not been studied in patients with severe renal impairment and is not recommended in this setting. The Update Committee suggests that bisphosphonate treatment continue for a period of 2 years. At 2 years, physicians should seriously consider discontinuing bisphosphonates in patients with responsive or stable disease, but further use is at the discretion of the treating physician. The Update Committee also discusses measures regarding ONJ.
published online ahead of print at www.jco.org on May 21, 2007.
Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
This article has been cited by other articles:
|
|
|
|
 
J. R. Berenson, O. Yellin, R. V. Boccia, M. Flam, S.-F. Wong, O. Batuman, M. M. Moezi, D. Woytowitz, H. Duvivier, Y. Nassir, et al.
Zoledronic Acid Markedly Improves Bone Mineral Density for Patients with Monoclonal Gammopathy of Undetermined Significance and Bone Loss
Clin. Cancer Res.,
October 1, 2008;
14(19):
6289 - 6295.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Terpos and M.-A. Dimopoulos
Genetic predisposition for the development of ONJ
Blood,
October 1, 2008;
112(7):
2596 - 2597.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. San Miguel, R. Schlag, N. K. Khuageva, M. A. Dimopoulos, O. Shpilberg, M. Kropff, I. Spicka, M. T. Petrucci, A. Palumbo, O. S. Samoilova, et al.
Bortezomib plus Melphalan and Prednisone for Initial Treatment of Multiple Myeloma
N. Engl. J. Med.,
August 28, 2008;
359(9):
906 - 917.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Dimopoulos, E. Kastritis, C. Bamia, I. Melakopoulos, D. Gika, M. Roussou, M. Migkou, E. Eleftherakis-Papaiakovou, D. Christoulas, E. Terpos, et al.
Reduction of osteonecrosis of the jaw (ONJ) after implementation of preventive measures in patients with multiple myeloma treated with zoledronic acid
Ann. Onc.,
August 9, 2008;
(2008)
mdn554v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
X. Li and L. K. McCauley
Osteonecrosis of the Jaw: Meeting Report from Skeletal Complications of Malignancy V: October 25-27, 2007 in Philadelphia, Pennsylvania, USA
IBMS BoneKEy,
August 1, 2008;
5(8):
289 - 293.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. I. Ripamonti, M. Maniezzo, T. Campa, E. Fagnoni, C. Brunelli, G. Saibene, C. Bareggi, L. Ascani, and E. Cislaghi
Decreased occurrence of osteonecrosis of the jaw after implementation of dental preventive measures in solid tumour patients with bone metastases treated with bisphosphonates. The experience of the National Cancer Institute of Milan
Ann. Onc.,
July 22, 2008;
(2008)
mdn526v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Khan
Bisphosphonate-associated osteonecrosis of the jaw
Can Fam Physician,
July 1, 2008;
54(7):
1019 - 1021.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Raje, S.-B. Woo, K. Hande, J. T. Yap, P. G. Richardson, S. Vallet, N. Treister, T. Hideshima, N. Sheehy, S. Chhetri, et al.
Clinical, Radiographic, and Biochemical Characterization of Multiple Myeloma Patients with Osteonecrosis of the Jaw
Clin. Cancer Res.,
April 15, 2008;
14(8):
2387 - 2395.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. B. Dodson, N. S. Raje, P. A. Caruso, and A. E. Rosenberg
Case 9-2008 -- A 65-Year-Old Woman with a Nonhealing Ulcer of the Jaw
N. Engl. J. Med.,
March 20, 2008;
358(12):
1283 - 1291.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Katzel, P. Hari, and D. H. Vesole
Multiple Myeloma: Charging Toward a Bright Future
CA Cancer J Clin,
September 1, 2007;
57(5):
301 - 318.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
