According to the results of a study published in the journal Cancer, repeated administration of Quadramet® (samarium sm-153 lexidronam) safely and effectively relieves pain from bone metastases in patients whose bone pain recurs after an initial response to Quadramet.
Bone is one of the most common locations in the body to which cancer metastasizes, or spreads. The major cancer types that tend to metastasize to bone include multiple myeloma, breast, prostate, lung, kidney, and thyroid cancers. Bone metastases cause damage that may make the bone more susceptible to complications such as pain and fractures.
The goal of treatment for bone metastases is to relieve pain and reduce the risk of fracture. Treatment may consist of surgery, radiation therapy, pain medications, and/or bisphosphonate drugs. Quadramet is an injection that delivers radiation to bone metastases, with the primary objective of relieving bone pain.
Most studies of Quadramet have involved treatment with a single dose. Because some patients may have a recurrence of bone pain after an initial response to Quadramet, it is important to determine whether additional doses of Quadramet are safe and effective.
To evaluate the safety and efficacy of repeated administration of Quadramet, researchers conducted a study among 55 patients with bone metastases who received at least two doses of Quadramet. The most common types of cancer among study participants were prostate cancer and breast cancer.
Patients who responded to a first dose of Quadramet, but then subsequently experienced a recurrence of bone pain, were eligible for additional doses of Quadramet. Patients had to have adequate blood cell counts in order to receive Quadramet.
• Grade 3 thrombocytopenia (low platelet levels) occurred in 11% of patients after the first dose of Quadramet, 12% of patients after the second dose of Quadramet, and 17% of patients after the third dose of Quadramet.
• After each dose of Quadramet, less than 7% of patients experienced grade 3 leukopenia (low white blood cell levels).
• Blood cell counts tended to recover by eight weeks after treatment.
• Each of the first three doses of Quadramet appeared to provide a similar degree of pain relief.
The researchers conclude that among patients who have an initial response to Quadramet but then have a recurrence of bone pain, repeated administration of Quadramet “is a reasonable treatment option” provided that patients have adequate blood cell counts.
Reference: Sartor O, Reid RH, Bushnell DL, Quick DP, Ell PJ. Safety and efficacy of repeat administration of samarium Sm-153 lexidronam to patients with metastatic bone pain. Cancer. 2007;109:637-43.
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