The Role of Bisphosphonates in Multiple Myeloma: Mechanisms, Side Effects, and the Future
The Role of Bisphosphonates in Multiple Myeloma: Mechanisms, Side Effects, and the Future
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DOI：
10.1634/theoncologist.2010-0225
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发表时间：
2011-01-01
期刊：
影响因子：
5.8
通讯作者：
Raje, Noopur
中科院分区：
文献类型：
--
作者：
Pozzi, Samantha;Raje, Noopur
唑来膦酸和帕米膦酸盐是两种有效的抗分解代谢含氮双膦酸盐（bp），广泛用于高骨转换疾病，如多发性骨髓瘤（MM）。在这篇综述中，我们将重点介绍它们的生物学和它们在MM中的当前和未来的应用，并强调一些最常见和新出现的副作用。虽然bp的主要靶细胞是破骨细胞，但新的见解表明，骨微环境的其他细胞类型也可能是靶标，包括成骨细胞、内皮细胞、免疫细胞和癌细胞。在这里，我们将重点关注bp治疗MM的现行指南，并解决诸如肾毒性、颌骨骨坏死和低能量骨折等副作用。最后，我们探讨了在其他骨靶向药物的背景下，BP在MM中使用的未来，评估了正在进行的临床试验，以解决MM患者BP给药的替代剂量和时间表。肿瘤学家2011；16:651 - 662
Zoledronic acid and pamidronate are two potent anti-catabolic nitrogen-containing bisphosphonates (BPs) used extensively in diseases with high bone turnover such as multiple myeloma (MM). In this review we focus on their biology and their current and future use in MM, and highlight some of the most common and emerging side effects. Although the primary target cells for BPs are osteoclasts, new insights suggest other cell types of the bone microenvironment as possible targets, including osteoblasts, endothelial cells, immune cells, and cancer cells. Here, we focus on the current guidelines for the use of BPs in MM and address side effects such as renal toxicity, osteonecrosis of the jaw, and low-energy fractures. Finally, we approach the future of BP use in MM in the context of other bone-targeted agents, evaluating ongoing clinical trials addressing alternate dosing and schedules of BP administration in MM patients. The Oncologist 2011;16:651-662