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Seventy cancer patients with malignant osteolytic bone  disease received pamidronate every three weeks for a maximum of six cycles. Bone  resorption parameters, urinary calcium excretion, and pain parameters were  assessed at baseline and throughout the study. At baseline, 80–95 % of patients  showed elevated urinary pyridinoline, deoxypyridinoline, Osteomark® NTx and  serum ICTP® levels, whereas only 35 % of patients had elevated urinary  CrossLaps® excretion rates. During bisphosphonate therapy, significant decreases  in Osteomark® NTx, CrossLaps® and calcium excretion were observed, which were  not related to the clinical outcome. The baseline levels of bone resorption  markers were used to predict the probability of non-progressive bone disease or  reduction in pain intensity during bisphosphonate therapy. Significant  predictors of non-progressive bone disease were urinary pyridinoline and serum  ICTP levels; significant predictors of reduction in pain intensity were urinary  free deoxypyridinoline and serum ICTP levels.

clinical chemistry and laboratory medicine

Diagnostic and Prognostic Value of Biochemical Markers in Malignant Bone Disease: A Prospective Study on the Effect of Bisphosphonate on Pain Intensity and Progression of Malignant Bone Disease