Clinical Edge

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

Cochrane on Bisphosphonates in Multiple Myeloma

Cochrane; 2017 Dec 18; Mhaskar, Kumar, et al

Bisphosphonates in patients with multiple myeloma (MM) reduces pathological vertebral fractures, skeletal-related events, and pain, according to a Cochrane review of 24 trials involving nearly 7,300 participants. Among the findings:

  • Bisphosphonates did not improve overall or disease progression-free survival.
  • They reduced overall fractures and fractures of the vertebra, but not non-vertebral fractures.
  • They alleviated pain, with osteonecrosis the only major adverse event (event rate of 1/1,000 patients treated).
  • Zoledronate was more efficacious than than etidronate and placebo, but it did not improve overall survival or other outcomes better than pamidronate or clodronate.
  • No specific aminobisphosphonate or non-aminobisphosphonate was found to be superior for any outcome.


Mhaskar R, Kumar A, Miladinovic B, Djulbegovic B. Bisphosphonates in multiple myeloma: An updated network meta-analysis. Cochrane Database of Systematic Reviews. 2017, Issue 12. Art. No.: CD003188. doi:10.1002/14651858.CD003188.pub4

This Week's Must Reads

Gene sequencing bone marrow in myelodysplastic syndrome, Duncavage EJ et al. N Engl J Med 2018;379:1028-41.

Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004

Genetic markers signal poor prognosis in MCL, Obr A et al. Clin Lymphoma Myeloma Leuk. 2018 Aug 23. doi: 10.1016/j.clml.2018.07.282

Disparities in ALL treatment toxicity, Taylor OA et al. Clin Cancer Res. 2018 Sep 11. doi: 10.1158/1078-0432.CCR-18-0939

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

Must Reads in Multiple Myeloma

Osteoporosis tied to mortality risk in women with multiple myeloma, Rosko AE et al. Clin Lymphoma Myeloma Leuk. 2018 Sep;18(9):597-602.e1.

Improved myeloma outcomes associated with having prescription drug coverage, Olszewski A et al. J Clin Oncol. 2018 Aug 16. doi: 10.1200/JCO.2018.77.8894

Simulated model could target myeloma treatment, Ubels J et al. Nat Commun. 2018 Jul 27. doi: 10.1038/s41467-018-05348-5.

Researchers propose frailty index for older patients with multiple myeloma, Mian HS et al. JCO Clin Cancer Inform. 2018 Jul 25. doi: 10.1200/CCI.18.00043.

Myeloma PFS boosted by elotuzumab add-on therapy, Dimopoulos MA et al. EHA (European Hematology Association) Congress, Abstract LB2606.