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.


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.

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.