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The use of zoledronic acid in pediatric cancer patients
Author(s) -
August Keith J.,
Dalton Amanda,
Katzenstein Howard M.,
George Bradley,
Olson Thomas A.,
WasilewskiMasker Karen,
Rapkin Louis B.
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22681
Subject(s) - zoledronic acid , medicine , bisphosphonate , cancer , hypophosphatemia , oncology , pediatric cancer , bone disease , bone pain , osteonecrosis of the jaw , surgery , osteoporosis
Background The third generation bisphosphonate zoledronic acid has demonstrated efficacy in reducing skeletal‐related events in adult patients with multiple cancer types that have skeletal disease. The use of zoledronic acid in pediatric oncology patients with bone metastases for the purpose of reducing pain, improving bone strength and altering the progression of metastatic disease has not been thoroughly evaluated. Procedure From October 2005 to December 2008, 19 patients at the Aflac Cancer Center received one or more doses of zoledronic acid as part of their therapy. A retrospective review of these patients was performed and information was collected including indication for treatment, toxicities, and outcomes. Results Most patients (n = 15) received zoledronic acid following relapse of their malignancy with metastatic disease present in one or more bony sites. Hypocalcemia and hypophosphatemia were frequent, but did not result in clinical symptoms. More significant toxicities associated with zoledronic acid, including clinically apparent renal insufficiency and osteonecrosis of the jaw, were not seen. Overall, zoledronic acid was well tolerated in this population. Conclusions The benefits of zoledronic acid seen in randomized trials of adults with bone metastases have sparked interest in its use for children with metastatic cancer. The administration of zoledronic acid in pediatric oncology appears safe, and may result in improved bone strength and pain control. Further evaluation is warranted to prospectively evaluate its efficacy and long‐term safety in pediatric patients with cancer and skeletal metastases. Pediatr Blood Cancer 2011;56:610–614. © 2010 Wiley‐Liss, Inc.