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Among patients with kidney cancer that has spread to the bone, the addition of thalidomide and interferon-y to treatment with Zometa® (zoledronic acid) did not appear to improve bone outcomes. These results were published in the journal Cancer.

Many patients with kidney cancer experience bone metastases, or spread of cancer to the bones. Bone metastases may ultimately cause debilitating bone pain, bone fractures, spinal compression (a life-threatening condition), and/or abnormalities in calcium levels in the blood and severely reduce a patient’s quality of life. Treatment for bone metastases is aimed primarily at reducing pain, delaying the time when fractures occur, or reversing hypercalcemia (high levels of calcium in the blood).

Bisphosphonates are a class of drugs used for the treatment of cancer-related hypercalcemia and of bone metastases in patients with advanced cancers. Bisphosphonates decrease the rate of bone destruction in patients with bone metastases. As well, clinical studies have demonstrated that bisphosphonates can significantly decrease the pain and number of fractures occurring from bone metastases.

In an attempt to further benefit patients treated with a bisphosphonate, researchers in Texas conducted a pilot study among 15 patients with kidney cancer that had spread to the bone. In addition to treatment with the bisphosphonate drug Zometa, patients were also treated with thalidomide and interferon-y.

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  • Two of the 15 patients experienced bone improvements following treatment with Zometa, thalidomide, and interferon-y. These patients experienced a reduction in pain and required less pain medication.
  • Forty-seven percent of patients experienced severe (grade 3 or grade 4) adverse effects of treatment. In some cases, however, these effects could have been due to the cancer itself or to other medications that the patients were taking. Two patients discontinued treatment because of adverse treatment effects.

The researchers conclude that among patients with metastatic kidney cancer, the effects of Zometa on bone do not appear to be greatly enhanced by the addition of thalidomide and interferon-y.

Reference: Tannir N, Jonasch E, Pagliaro LC et al. Pilot Trial of Bone-targeted Therapy with Zoledronate, Thalidomide, and Interferon-y for Metastatic Renal Cell Carcinoma. Cancer. 2006;107:497-505.

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