Bisphosphonates May Be Useful as Palliative Measure in Selected Patients

the ONA take:

Bisphosphonates may improve symptoms of hypercalcemia and prolong survival in patients with malignancy-associated hypercalcemia receiving palliative care, a new study published online ahead of print in the journal Supportive Care in Cancer has shown.

Because hypercalcemia can be a potentially fatal paraneoplastic complication of malignancy, researchers sought to determine the reversibility of hypercalcemia amongst patients not receiving treatment for their underlying malignancy and assess whether calcium correction improves symptoms.

For the study, researchers analyzed data from 63 patients with evidence of malignancy-associated hypercalcemia being treated with bisphosphonates. Results showed that 36 of the 63 participants achieved normal calcium levels following treatment with an intravenous bisphosphonate.

Researchers found that history of hypercalcemia in the past, age, and albumin levels impacted whether patients achieved a complete response. The study also demonstrated that a reduction in calcium level was associated with significantly improved survival and symptoms regardless of whether patients achieved normal calcium levels.

Malignancy-associated hypercalcemia typically manifests during the advanced phase of cancer, when the life expectancy of patients ranges from weeks to months.

Although bisphosphonates are the mainstay of treatment for this complication, they are not typically used in a palliative population.

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Bisphosphonates may improve symptoms of hypercalcemia and prolong survival in patients receiving palliative care.
Hypercalcaemia is a potentially fatal paraneoplastic complication of malignancy. It primarily manifests during the advanced phase of cancer, with the life expectancy of patients ranging from weeks to months. The mainstay of treatment is with bisphosphonates, but these are not frequently used in a palliative population due to potential conflict with goals of care.
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