Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane On Bisphosphonates for Prostate Cancer

Cochrane; 2017 Dec 26; Macherey, Monsef, et al

Men with bone metastases from prostate who took bisphosphonates or control regimens experienced similar responses to pain, according to a Cochrane review of 18 clinical trials. The reviews found that bisphosphonates:

  • Provided no clinically relevant difference in pain response vs placebo or no additional treatment, based on low quality evidence.
  • Reduced pain in 40 more men/1,000.
  • Appear to result in 58 fewer skeletal-related events/1,000.
  • Showed no clear difference in the number of men who died or took fewer pain killers.
  • Probably increased the number of men with nausea, based on moderate quality evidence.
  • Probably increased the number of men with kidney problems, based on moderate quality evidence.
  • Showed no clear difference in patients who experienced osteonecrosis of the jaw, based on very low quality evidence.
  • Probably decreased the number of men affected by disease progression, according to moderate quality evidence.

Citation:

Macherey S, Monsef I, Jahn F, et al. Bisphosphonates for advanced prostate cancer. Cochrane Database of Syst Rev. 2017, Issue 12. Art. No.: CD006250. doi:10.1002/14651858.CD006250.pub2.

This Week's Must Reads

Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005

Thrombolysis for acute ischemic stroke safe in GI malignancy, Inohara T et al. Circulation. 2018 Nov 6;138[suppl 1], Abstract A12291

Ten years of anastrozole boosts disease-free survival, Ohtani S et al. SABCS 2018, Abstract GS3-04

TAO: Nonwhite ethnicity, limb infection predict poor prognosis, Le Joncour A et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 1885

Must Reads in Genitourinary Cancer

Leptin expression may aid in differentiation of renal lesions, Gobe G et al. Pathology. 2018 Aug;50(5):504-10

Hypofractionated radiation offers 'tailored treatment' approach to RCC mets, Felice F et al. Crit Rev Oncol Hematol. 2018 Aug 1. doi: 10.1016/j.critrevonc.2018.06.002.

Concern over SREs rises with increasing incidence of metastatic RCC, Umer M et al. Ann Med Surg. 2018 Jan 21. doi: 10.1016/j.amsu.2018.01.002

Radioactive agent approved for adrenal tumors, FDA approves iobenguane I 131 injection (Azedra) for IV use for the treatment of pheochromocytoma or paraganglioma.